Provider Demographics
NPI:1760864243
Name:COOKS, CARMEN (LIMHP)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:COOKS
Suffix:
Gender:
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11404 W DODGE RD STE 300
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-9603
Mailing Address - Country:US
Mailing Address - Phone:402-898-1113
Mailing Address - Fax:402-819-5588
Practice Address - Street 1:11404 W DODGE RD STE 300
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154-9603
Practice Address - Country:US
Practice Address - Phone:402-898-1113
Practice Address - Fax:402-819-5588
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-22
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10538101YM0800X
NE2391101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health