Provider Demographics
NPI:1639741002
Name:COOK, JANE MARIE (MA, LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:MARIE
Last Name:COOK
Suffix:
Gender:F
Credentials:MA, LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 NAVIDAD ST
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77801-2818
Mailing Address - Country:US
Mailing Address - Phone:832-458-9555
Mailing Address - Fax:
Practice Address - Street 1:1100 BRIARCREST DR
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2529
Practice Address - Country:US
Practice Address - Phone:979-229-7636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-14
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX97435101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health