Provider Demographics
NPI:1548902190
Name:COOK, KATHERINE M (MA, LPC LCDC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:M
Last Name:COOK
Suffix:
Gender:F
Credentials:MA, LPC LCDC
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:M
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2400 S POLK ST APT 112
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-2858
Mailing Address - Country:US
Mailing Address - Phone:806-676-5089
Mailing Address - Fax:
Practice Address - Street 1:2400 S POLK ST APT 112
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-2858
Practice Address - Country:US
Practice Address - Phone:806-676-5089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-12
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX87719101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health