| Cook Psychological Services, Llc | |
|
604 Eastgate St Carbondale IL 62901-3304 | |
| (618) 203-4790 | |
| (618) 305-8449 |
| Full Name | Cook Psychological Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 604 Eastgate St, Carbondale, Illinois |
| Authorized Official Name and Position | Robert F Cook (OWNER) |
| Authorized Official Contact | 6182034790 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cook Psychological Services, Llc Po Box 791 Carbondale IL 62903-0791 Ph: (618) 203-4790 | Cook Psychological Services, Llc 604 Eastgate St Carbondale IL 62901-3304 Ph: (618) 203-4790 |
| NPI Number | 1366131948 |
|---|---|
| Provider Enumeration Date | 05/01/2023 |
| Last Update Date | 04/06/2024 |
| Certification Date | 04/06/2024 |
| Medicare PECOS PAC ID | 1759737893 |
|---|---|
| Medicare Enrollment ID | O20231026001683 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366131948 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | (* (Not Available)) | Primary |
| Provider Name | Robert Francis Cook |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912692591 PECOS PAC ID: 2668828708 Enrollment ID: I20231026001872 |
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