Cook, Jason T.
Cook, Jason T. is an individual health care provider with primary practice located at 7230 Engle Rd Ste 304, Fort Wayne IN 46804-2209. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Cook, Jason T. can be contacted via phone (260) 483-2400.Contact Information
Primary practice address
7230 Engle Rd Ste 304
Fort Wayne IN 46804-2209
Phone: (260) 483-2400
Fax: (260) 960-9361
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 20041587A | Indiana |
Profile Details
| NPI number | 1043283641 |
|---|---|
| LBN Legal business name | Cook, Jason T. |
| Credentials | PSY.D., HSPP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 13th, 2006 |
| Last updated | Oct 2nd, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043283641 | NPPES |
| Indiana | MEDICAID | 200290630 |
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