Provider Demographics
NPI:1881954477
Name:COOK, JAMES BRIAN (MS)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:BRIAN
Last Name:COOK
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 SECOND ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:TN
Mailing Address - Zip Code:38340-1926
Mailing Address - Country:US
Mailing Address - Phone:304-677-9504
Mailing Address - Fax:
Practice Address - Street 1:60 LYNOAK COVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301
Practice Address - Country:US
Practice Address - Phone:731-668-7593
Practice Address - Fax:731-660-7512
Is Sole Proprietor?:No
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health