Provider Demographics
NPI:1538860655
Name:COOKE, ANDREA MARIA (PHD)
Entity type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:MARIA
Last Name:COOKE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:ANDREA
Other - Middle Name:MARIA
Other - Last Name:COOKE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:57 PALM ST APT 337
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060-3271
Mailing Address - Country:US
Mailing Address - Phone:708-381-9088
Mailing Address - Fax:
Practice Address - Street 1:57 PALM ST APT 337
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060-3271
Practice Address - Country:US
Practice Address - Phone:708-381-9088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.0104531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical