Provider Demographics
NPI:1700393162
Name:COOTECARE COUNSELING
Entity Type:Organization
Organization Name:COOTECARE COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:COOTE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:912-660-7358
Mailing Address - Street 1:127 ABERCORN ST STE 301B
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31401-4069
Mailing Address - Country:US
Mailing Address - Phone:833-232-6638
Mailing Address - Fax:833-569-3858
Practice Address - Street 1:127 ABERCORN ST STE 301B
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31401-4069
Practice Address - Country:US
Practice Address - Phone:833-232-6638
Practice Address - Fax:833-569-3858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-08
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0031251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1487012894OtherINDIVIDUAL NPI