Provider Demographics
NPI:1346683828
Name:COOK, APRIL MICHELLE
Entity Type:Individual
Prefix:MS
First Name:APRIL
Middle Name:MICHELLE
Last Name:COOK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:APRIL
Other - Middle Name:MICHELLE
Other - Last Name:SHAVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2704 SPRING VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CLEARLAKE OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95423-9513
Mailing Address - Country:US
Mailing Address - Phone:707-295-4469
Mailing Address - Fax:
Practice Address - Street 1:2704 SPRING VALLEY RD
Practice Address - Street 2:
Practice Address - City:CLEARLAKE OAKS
Practice Address - State:CA
Practice Address - Zip Code:95423-9513
Practice Address - Country:US
Practice Address - Phone:707-295-4469
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARS8068101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)