Provider Demographics
NPI:1366129397
Name:COOK, JORDYN ELIZABETH (LLBSW)
Entity type:Individual
Prefix:MRS
First Name:JORDYN
Middle Name:ELIZABETH
Last Name:COOK
Suffix:
Gender:F
Credentials:LLBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MULHOLLAND ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-7693
Mailing Address - Country:US
Mailing Address - Phone:989-895-2300
Mailing Address - Fax:989-895-2390
Practice Address - Street 1:1961 PARISH RD
Practice Address - Street 2:
Practice Address - City:KAWKAWLIN
Practice Address - State:MI
Practice Address - Zip Code:48631-9459
Practice Address - Country:US
Practice Address - Phone:989-684-2531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-30
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6852093716171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator