Provider Demographics
NPI:1952558579
Name:COOK, STEVEN WAYNE (LAC; AADC; CCGC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:WAYNE
Last Name:COOK
Suffix:
Gender:M
Credentials:LAC; AADC; CCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 13424
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71315-3424
Mailing Address - Country:US
Mailing Address - Phone:318-448-0082
Mailing Address - Fax:318-290-3000
Practice Address - Street 1:3600 JACKSON ST. EXT.
Practice Address - Street 2:SUITE 128
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303
Practice Address - Country:US
Practice Address - Phone:318-448-0082
Practice Address - Fax:318-290-3000
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-26
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
LALAC#1303101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)