Provider Demographics
NPI:1558410829
Name:COOK, CATHERINE Y (LMHP, LADC)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:Y
Last Name:COOK
Suffix:
Gender:F
Credentials:LMHP, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 EVANS STREET
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111
Mailing Address - Country:US
Mailing Address - Phone:402-510-3643
Mailing Address - Fax:402-991-3948
Practice Address - Street 1:3525 EVANS STREET
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68104
Practice Address - Country:US
Practice Address - Phone:402-510-3643
Practice Address - Fax:402-991-8162
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7375101YM0800X
NE3416101YM0800X
NE843101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025018500Medicaid