Provider Demographics
NPI:1518226695
Name:COOK, KEVIN KEITH SUTTON (LPC)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:KEITH SUTTON
Last Name:COOK
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2531
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08260-8531
Mailing Address - Country:US
Mailing Address - Phone:814-504-4923
Mailing Address - Fax:
Practice Address - Street 1:125 CREST HAVEN RD
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-1652
Practice Address - Country:US
Practice Address - Phone:609-465-4100
Practice Address - Fax:609-465-2588
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2012-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC004308001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical