Provider Demographics
NPI:1649737362
Name:COOK, SHAWNDRIKA LATRICE (LPC)
Entity Type:Individual
Prefix:MS
First Name:SHAWNDRIKA
Middle Name:LATRICE
Last Name:COOK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 GADSDEN HWY APT H171
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-2484
Mailing Address - Country:US
Mailing Address - Phone:205-709-7617
Mailing Address - Fax:
Practice Address - Street 1:544 GADSDEN HWY APT H171
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-2484
Practice Address - Country:US
Practice Address - Phone:205-709-7617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-28
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3830101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional