| Trudy Cook Lcsw, Casac | |
|
307 Vesta Ct Surf City NC 28445-6684 | |
| (631) 478-2649 | |
| Not Available |
| Full Name | Trudy Cook Lcsw, Casac |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 307 Vesta Ct, Surf City, North Carolina |
| Authorized Official Name and Position | Trudy Mary Cook (OWNER) |
| Authorized Official Contact | 6314782649 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Trudy Cook Lcsw, Casac Po Box 2116 Surf City NC 28445-0018 Ph: (631) 478-2649 | Trudy Cook Lcsw, Casac 307 Vesta Ct Surf City NC 28445-6684 Ph: (631) 478-2649 |
| NPI Number | 1033642590 |
|---|---|
| Provider Enumeration Date | 04/11/2017 |
| Last Update Date | 08/07/2024 |
| Certification Date | 08/07/2024 |
| Medicare PECOS PAC ID | 5890157408 |
|---|---|
| Medicare Enrollment ID | O20230815000227 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033642590 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | 9315235 (New York) | Primary |
| Provider Name | Trudy M Cook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174847206 PECOS PAC ID: 5991062077 Enrollment ID: I20230815000315 |
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