Cooke, Michael David

Cooke, Michael David is an individual health care provider with primary practice located at 1062 State Route 38 , Owego NY 13827. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Cooke, Michael David can be contacted via phone (607) 687-4000.

Contact Information

Primary practice address
1062 State Route 38 Owego NY 13827
Phone: (607) 687-4000
Fax: (607) 687-6396
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 17573 New York
Behavioral Health & Social Service Providers / Clinical 1041C0700X 067008-1 New York
Behavioral Health & Social Service Providers / Clinical 1041C0700X 079001 New York

Profile Details

NPI number 1285789180
LBN Legal business name Cooke, Michael David
Credentials LCSW-R
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2007
Last updated Dec 31st, 2013 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285789180 NPPES
New York MEDICAID 00618162
New York Other 17573
New York Other 079001
New York Other 067008-1

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