Provider Demographics
NPI:1336331560
Name:COOKE, ROBERT LAWSON (DMIN)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:LAWSON
Last Name:COOKE
Suffix:
Gender:M
Credentials:DMIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 W MILLBROOK RD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-4389
Mailing Address - Country:US
Mailing Address - Phone:919-845-9977
Mailing Address - Fax:919-845-9761
Practice Address - Street 1:312 W MILLBROOK RD
Practice Address - Street 2:SUITE 109
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-4389
Practice Address - Country:US
Practice Address - Phone:919-845-9977
Practice Address - Fax:919-845-9761
Is Sole Proprietor?:No
Enumeration Date:2007-08-12
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC67101YP1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral