Provider Demographics
NPI:1932963279
Name:COOKE, SARAH MARIE (CSW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:MARIE
Last Name:COOKE
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2285 EXECUTIVE DR STE 325
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40505-4883
Mailing Address - Country:US
Mailing Address - Phone:859-251-8782
Mailing Address - Fax:
Practice Address - Street 1:2285 EXECUTIVE DR STE 325
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505-4883
Practice Address - Country:US
Practice Address - Phone:859-251-8782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2588091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical