Provider Demographics
NPI:1669544268
Name:COOK, MARIANNE (LICSW)
Entity type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 MASSACHUSETTS AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-2100
Mailing Address - Country:US
Mailing Address - Phone:617-545-5335
Mailing Address - Fax:
Practice Address - Street 1:2000 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-2115
Practice Address - Country:US
Practice Address - Phone:617-545-5335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0956721041C0700X
MA1148351041C0700X
CT130061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical