Provider Demographics
NPI:1679613640
Name:COOK, ALAN LEE (LPC, LAC, MAC)
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:LEE
Last Name:COOK
Suffix:
Gender:M
Credentials:LPC, LAC, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 FRIENDSHIP LN
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80904-1815
Mailing Address - Country:US
Mailing Address - Phone:719-445-9525
Mailing Address - Fax:719-473-6431
Practice Address - Street 1:33 FRIENDSHIP LN
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-1815
Practice Address - Country:US
Practice Address - Phone:719-445-9525
Practice Address - Fax:719-473-6431
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLAC101YA0400X
COLPC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health