Provider Demographics
NPI:1649150277
Name:COOK, EILEEN (CSW)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:
Last Name:COOK
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3147 CUSTER DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40517-4020
Mailing Address - Country:US
Mailing Address - Phone:859-447-0855
Mailing Address - Fax:859-479-1090
Practice Address - Street 1:1002 S VIRGINIA ST STE 401
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-3507
Practice Address - Country:US
Practice Address - Phone:859-447-0855
Practice Address - Fax:859-479-1090
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY00001028104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker