Provider Demographics
NPI:1275179715
Name:COOKE, KATI MAARIA
Entity Type:Individual
Prefix:
First Name:KATI
Middle Name:MAARIA
Last Name:COOKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 SHELBOURNE CT
Mailing Address - Street 2:
Mailing Address - City:NISKAYUNA
Mailing Address - State:NY
Mailing Address - Zip Code:12309-2518
Mailing Address - Country:US
Mailing Address - Phone:517-748-8011
Mailing Address - Fax:
Practice Address - Street 1:401 NEW KARNER RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-3854
Practice Address - Country:US
Practice Address - Phone:518-431-1650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-19
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker