Provider Demographics
NPI:1205451499
Name:COOK, DAVID (LSCSW)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:COOK
Suffix:
Gender:M
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 HUMBOLDT ST
Mailing Address - Street 2:STE 110
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-6095
Mailing Address - Country:US
Mailing Address - Phone:785-799-5666
Mailing Address - Fax:785-396-4399
Practice Address - Street 1:630 HUMBOLDT ST
Practice Address - Street 2:STE 110
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-6095
Practice Address - Country:US
Practice Address - Phone:785-799-5666
Practice Address - Fax:785-396-4399
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS059361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical