Provider Demographics
NPI:1538437033
Name:COOKE, SUZANNE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:
Last Name:COOKE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3150 WINDSONG DRIVE
Mailing Address - Street 2:#4112
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-7786
Mailing Address - Country:US
Mailing Address - Phone:850-893-6318
Mailing Address - Fax:
Practice Address - Street 1:3150 WINDSONG DR
Practice Address - Street 2:#4112
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-7787
Practice Address - Country:US
Practice Address - Phone:850-893-6318
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW104261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical