Provider Demographics
NPI:1487992541
Name:ELIZABETH E. VENTURA-COOK, PHD, PLLC
Entity type:Organization
Organization Name:ELIZABETH E. VENTURA-COOK, PHD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:EUGENIO
Authorized Official - Last Name:VENTURA-COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-718-5054
Mailing Address - Street 1:9414 E SAN SALVADOR DR
Mailing Address - Street 2:SUITE 228
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5527
Mailing Address - Country:US
Mailing Address - Phone:480-718-5054
Mailing Address - Fax:480-718-5054
Practice Address - Street 1:9414 E SAN SALVADOR DR
Practice Address - Street 2:SUITE 228
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5527
Practice Address - Country:US
Practice Address - Phone:480-718-5054
Practice Address - Fax:480-718-5054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3587103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ131417Medicare PIN