Provider Demographics
NPI:1336438183
Name:ROSENBAUM-COOKS, KEREN (LCSW)
Entity Type:Individual
Prefix:
First Name:KEREN
Middle Name:
Last Name:ROSENBAUM-COOKS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 W BELMONT AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3240
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:71 W 23RD ST
Practice Address - Street 2:704
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4102
Practice Address - Country:US
Practice Address - Phone:212-576-4104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0253781041C0700X
NY0792901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical