Provider Demographics
NPI:1851932305
Name:COOK, JORDAN MARIA (LCSW)
Entity Type:Individual
Prefix:
First Name:JORDAN
Middle Name:MARIA
Last Name:COOK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 NEWHAVEN CT
Mailing Address - Street 2:
Mailing Address - City:GROVETOWN
Mailing Address - State:GA
Mailing Address - Zip Code:30813
Mailing Address - Country:US
Mailing Address - Phone:404-429-5585
Mailing Address - Fax:
Practice Address - Street 1:3351 WRIGHTSBORO RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30909-2800
Practice Address - Country:US
Practice Address - Phone:706-868-5011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker