Provider Demographics
NPI:1568481943
Name:COOK, ALLISON G (LCSW)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:G
Last Name:COOK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:G
Other - Last Name:CHAMBERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 2697
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42102-7697
Mailing Address - Country:US
Mailing Address - Phone:270-745-1467
Mailing Address - Fax:270-745-1156
Practice Address - Street 1:825 SECOND AVENUE EAST
Practice Address - Street 2:SUITE A4
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-1789
Practice Address - Country:US
Practice Address - Phone:270-796-6564
Practice Address - Fax:270-780-2793
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY14651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY30604011Medicaid
KY0572414Medicare PIN
KY0570411Medicare PIN
KY8760Medicare ID - Type UnspecifiedGROUP