Provider Demographics
NPI:1366093072
Name:COOK, BRITTANY M (LPAT, ATR-BC, LPCC)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:M
Last Name:COOK
Suffix:
Gender:F
Credentials:LPAT, ATR-BC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4722 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40214-2124
Mailing Address - Country:US
Mailing Address - Phone:502-938-8255
Mailing Address - Fax:
Practice Address - Street 1:4010 DUPONT CIR STE 419
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4837
Practice Address - Country:US
Practice Address - Phone:502-409-6993
Practice Address - Fax:502-409-6775
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-24
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY252714221700000X
KY267462101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist