Cook, Stacey
Cook, Stacey is an sole proprietor health care provider with primary practice located at 2789 Ortiz Ave , Fort Myers FL 33905-7806. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Cook, Stacey can be contacted via phone (239) 791-1546.Contact Information
Primary practice address
2789 Ortiz Ave
Fort Myers FL 33905-7806
Phone: (239) 791-1546
Fax: (239) 275-3103
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X | SW7300 | Florida |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | SW7300 | Florida |
Profile Details
| NPI number | 1336364926 |
|---|---|
| LBN Legal business name | Cook, Stacey |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 17th, 2007 |
| Last updated | Apr 9th, 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 | 1336364926 | NPPES |
| Florida | MEDICAID | 767939400 |
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