Provider Demographics
NPI:1477511723
Name:COOK, MARILYN L (LSCSW)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:L
Last Name:COOK
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:MARILYN
Other - Middle Name:L
Other - Last Name:HULCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:934 N WATER ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-3838
Mailing Address - Country:US
Mailing Address - Phone:316-660-7600
Mailing Address - Fax:316-941-5075
Practice Address - Street 1:934 N WATER ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-3838
Practice Address - Country:US
Practice Address - Phone:316-660-7600
Practice Address - Fax:316-941-5075
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS10061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical