Provider Demographics
NPI:1578517348
Name:COOK, SCOTT PATRICK (MSW)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:PATRICK
Last Name:COOK
Suffix:
Gender:M
Credentials:MSW
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 807
Mailing Address - Street 2:
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-0807
Mailing Address - Country:US
Mailing Address - Phone:603-508-1754
Mailing Address - Fax:
Practice Address - Street 1:183 ROCKINGHAM ROAD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087
Practice Address - Country:US
Practice Address - Phone:603-434-9937
Practice Address - Fax:603-434-0427
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NH13331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor