Provider Demographics
NPI:1568125250
Name:COOK, LEANN (LMHC)
Entity Type:Individual
Prefix:
First Name:LEANN
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 REID ST
Mailing Address - Street 2:
Mailing Address - City:FORT PLAIN
Mailing Address - State:NY
Mailing Address - Zip Code:13339-1339
Mailing Address - Country:US
Mailing Address - Phone:518-396-8372
Mailing Address - Fax:
Practice Address - Street 1:106 REID ST
Practice Address - Street 2:
Practice Address - City:FORT PLAIN
Practice Address - State:NY
Practice Address - Zip Code:13339-1339
Practice Address - Country:US
Practice Address - Phone:518-396-8372
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health