Provider Demographics
NPI:1205940251
Name:COOK, JANE OGLESBY (PHD, LPC)
Entity type:Individual
Prefix:DR
First Name:JANE
Middle Name:OGLESBY
Last Name:COOK
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 WHITE BLVD
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-5022
Mailing Address - Country:US
Mailing Address - Phone:228-875-2570
Mailing Address - Fax:
Practice Address - Street 1:111 WHITE BLVD
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-5022
Practice Address - Country:US
Practice Address - Phone:228-875-2570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0115101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health