Provider Demographics
NPI:1730278821
Name:COOK, JO ANNE (MA LPC LCDC BCIA-C)
Entity Type:Individual
Prefix:MRS
First Name:JO ANNE
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:MA LPC LCDC BCIA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 S WASHINGTON ST
Mailing Address - Street 2:STE. 206
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79102-2610
Mailing Address - Country:US
Mailing Address - Phone:806-322-2200
Mailing Address - Fax:806-322-2201
Practice Address - Street 1:1800 S WASHINGTON ST
Practice Address - Street 2:STE. 206
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79102-2610
Practice Address - Country:US
Practice Address - Phone:806-322-2200
Practice Address - Fax:806-322-2201
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8030101YA0400X
TX13863101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX235868OtherVALUE OPTIONS
TX-0004OtherCOMPCARE
TX84829LOtherBCBS OF TEXAS PROVIDER #
TX126868OtherCHIPS
TX03026OtherAETNA NETWORK ID
TX1062396OtherCIGNA
TX10735092OtherCAQH
TX267225OtherCOMPSYCH
TX5467561OtherAETNA INSURANCE COMPANY
TX0032NFOtherBCBS GROUP NUMBER
TX211395OtherFIRST HEALTH
TXA007291OtherVALUE OPTIONS VENDOR #