Provider Demographics
NPI:1558816603
Name:COOKE, LUCIANN (LCSW, LCADC)
Entity Type:Individual
Prefix:
First Name:LUCIANN
Middle Name:
Last Name:COOKE
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:NJ
Mailing Address - Zip Code:07940-1510
Mailing Address - Country:US
Mailing Address - Phone:848-482-1089
Mailing Address - Fax:
Practice Address - Street 1:90 E HALSEY RD STE 369
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054
Practice Address - Country:US
Practice Address - Phone:848-482-1089
Practice Address - Fax:848-217-0011
Is Sole Proprietor?:No
Enumeration Date:2016-08-18
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00276500101YA0400X
NJ44SC058310001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)