Provider Demographics
NPI:1750945945
Name:COOK, CAITLYN EILEEN (LCPC)
Entity type:Individual
Prefix:
First Name:CAITLYN
Middle Name:EILEEN
Last Name:COOK
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 DEER HILL RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:ME
Mailing Address - Zip Code:04037-3100
Mailing Address - Country:US
Mailing Address - Phone:206-697-2020
Mailing Address - Fax:
Practice Address - Street 1:69 DEER HILL RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:ME
Practice Address - Zip Code:04037-3100
Practice Address - Country:US
Practice Address - Phone:206-697-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-24
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC4921101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional