Provider Demographics
NPI:1942323159
Name:COOK, KAREN MARIE (MSW)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:MARIE
Last Name:COOK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:KARENMARIE
Other - Middle Name:
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:PO BOX 130831
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77219-0831
Mailing Address - Country:US
Mailing Address - Phone:832-778-1642
Mailing Address - Fax:832-778-1642
Practice Address - Street 1:1100 MACARTHUR ST
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-3640
Practice Address - Country:US
Practice Address - Phone:281-342-3500
Practice Address - Fax:832-778-1642
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX093921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0406118-02Medicaid