Provider Demographics
NPI:1962633487
Name:COOK, MARY ELLEN (MA)
Entity Type:Individual
Prefix:
First Name:MARY ELLEN
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 NEWTOWN-LANGHORNE ROAD
Mailing Address - Street 2:ONE SUMMIT SQUARE, SUITE 304
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1091
Mailing Address - Country:US
Mailing Address - Phone:215-882-4445
Mailing Address - Fax:
Practice Address - Street 1:1717 NEWTOWN-LANGHORNE ROAD
Practice Address - Street 2:ONE SUMMIT SQUARE, SUITE 304
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1091
Practice Address - Country:US
Practice Address - Phone:215-882-4445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-31
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional