Provider Demographics
NPI:1841786803
Name:COOKE, LINDSAY (LMHC)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:COOKE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 NE 5TH AVE STE D
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-5661
Mailing Address - Country:US
Mailing Address - Phone:516-507-0261
Mailing Address - Fax:
Practice Address - Street 1:200 W CAMINO REAL STE 200X
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-5944
Practice Address - Country:US
Practice Address - Phone:516-507-0261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-02
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12589101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health