Provider Demographics
NPI:1346370889
Name:COOK, THOMAS FRANKLIN (DSW, CSW)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:FRANKLIN
Last Name:COOK
Suffix:
Gender:M
Credentials:DSW, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:724 DIVIDING RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-1711
Mailing Address - Country:US
Mailing Address - Phone:205-733-8162
Mailing Address - Fax:
Practice Address - Street 1:350 CANYON PARK DR
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-4819
Practice Address - Country:US
Practice Address - Phone:205-664-8721
Practice Address - Fax:205-664-7598
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0497C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-39407Medicare UPIN
AL515-20700Medicare UPIN