Provider Demographics
NPI:1710194048
Name:COOK, CHRISTINE LYNN (LCSW, ATR-BC)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:LYNN
Last Name:COOK
Suffix:
Gender:F
Credentials:LCSW, ATR-BC
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:COOK
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, ATR-BC
Mailing Address - Street 1:401 SHADY AVE
Mailing Address - Street 2:SUITE B-106
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-4409
Mailing Address - Country:US
Mailing Address - Phone:412-441-2074
Mailing Address - Fax:
Practice Address - Street 1:401 SHADY AVE
Practice Address - Street 2:SUITE B-106
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-4409
Practice Address - Country:US
Practice Address - Phone:412-441-2074
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0149581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA01832525OtherHIGHMARK PROVIDER NUMBER