Provider Demographics
NPI:1306086343
Name:COOK, JULIENE SIMPSON (MS, NBCT, LPC)
Entity type:Individual
Prefix:
First Name:JULIENE
Middle Name:SIMPSON
Last Name:COOK
Suffix:
Gender:F
Credentials:MS, NBCT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 TIMBERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WYLIE
Mailing Address - State:SC
Mailing Address - Zip Code:29710-9009
Mailing Address - Country:US
Mailing Address - Phone:803-831-8747
Mailing Address - Fax:
Practice Address - Street 1:5903 DEAL RD
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28104-7973
Practice Address - Country:US
Practice Address - Phone:704-814-9772
Practice Address - Fax:704-814-9775
Is Sole Proprietor?:No
Enumeration Date:2009-03-04
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4492101YP2500X
NC101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional