Provider Demographics
NPI:1629663711
Name:COOK, CINDY (DSW LCSW)
Entity Type:Individual
Prefix:DR
First Name:CINDY
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:DSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21315 S TIMBER TRL
Mailing Address - Street 2:
Mailing Address - City:SHOREWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60404-8242
Mailing Address - Country:US
Mailing Address - Phone:815-690-2447
Mailing Address - Fax:
Practice Address - Street 1:21315 S TIMBER TRL
Practice Address - Street 2:
Practice Address - City:SHOREWOOD
Practice Address - State:IL
Practice Address - Zip Code:60404-8242
Practice Address - Country:US
Practice Address - Phone:815-690-2447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0103011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical