Provider Demographics
NPI:1659579589
Name:COOKE, THOMAS S (PHD, LPC)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:S
Last Name:COOKE
Suffix:
Gender:M
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 1:1110 ROSE HILL DR STE 201
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22903-5159
Mailing Address - Country:US
Mailing Address - Phone:434-806-2193
Mailing Address - Fax:
Practice Address - Street 1:1110 ROSE HILL DR STE 201
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-5159
Practice Address - Country:US
Practice Address - Phone:434-806-2193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health