Provider Demographics
NPI:1871644674
Name:COOKE, DOUGLAS M (LPC, LMFT)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:M
Last Name:COOKE
Suffix:
Gender:M
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1001
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976
Mailing Address - Country:US
Mailing Address - Phone:256-582-8880
Mailing Address - Fax:256-582-8890
Practice Address - Street 1:1612 RAILROAD AVENUE
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976
Practice Address - Country:US
Practice Address - Phone:256-582-8880
Practice Address - Fax:256-582-8890
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL922101Y00000X
AL77101Y00000X
ALLPC-922101Y00000X, 101YP2500X, 101YM0800X
ALLMFT-77106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51510017COOOtherFEDERAL BCBS
AL51520233COOOtherBCBS OF ALABAMA