Provider Demographics
NPI:1851883557
Name:COOK, CODY MICHIKO (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:CODY
Middle Name:MICHIKO
Last Name:COOK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:CODY
Other - Middle Name:M
Other - Last Name:MCBRAYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1144 MATTIE POINTE BLVD
Mailing Address - Street 2:
Mailing Address - City:AUBURNDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33823-3749
Mailing Address - Country:US
Mailing Address - Phone:808-927-3219
Mailing Address - Fax:
Practice Address - Street 1:1144 MATTIE POINTE BLVD
Practice Address - Street 2:
Practice Address - City:AUBURNDALE
Practice Address - State:FL
Practice Address - Zip Code:33823-3749
Practice Address - Country:US
Practice Address - Phone:808-927-3219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH22362101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health