Provider Demographics
NPI:1952938136
Name:CROOK, DOUGLAS S (DNP, RN, PMHNP-BC)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:S
Last Name:CROOK
Suffix:
Gender:M
Credentials:DNP, RN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:872 MASSACHUSETTS AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-3073
Mailing Address - Country:US
Mailing Address - Phone:617-395-5806
Mailing Address - Fax:
Practice Address - Street 1:872 MASSACHUSETTS AVE UNIT 2
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02139-3073
Practice Address - Country:US
Practice Address - Phone:617-395-5806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2264271363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health