Provider Demographics
NPI:1326345125
Name:COOK, JOY E (LICSW)
Entity Type:Individual
Prefix:MS
First Name:JOY
Middle Name:E
Last Name:COOK
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:290 OSBORNE RD
Mailing Address - Street 2:
Mailing Address - City:WARE
Mailing Address - State:MA
Mailing Address - Zip Code:01082-9216
Mailing Address - Country:US
Mailing Address - Phone:413-668-8535
Mailing Address - Fax:978-355-3502
Practice Address - Street 1:35 SOUTH ST
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:MA
Practice Address - Zip Code:01005-0232
Practice Address - Country:US
Practice Address - Phone:413-668-8535
Practice Address - Fax:978-355-3502
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-15
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1160541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110112093BMedicaid