Diedre Cook, MA
Individual provider Active NPI Counselor · Logansport, IN
NPI 1245754753 · NPPES record last updated Jul 27, 2017
Key facts
- NPI
- 1245754753
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 1015 Michigan Ave
Logansport, IN 46947-1526 - Phone
- (574) 722-5151
- NPI assigned
- Jul 27, 2017
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Yes |
Addresses
Primary practice location
1015 Michigan Ave
Logansport, IN 46947-1526
Mailing address
800 Fulton St
Logansport, IN 46947-1577
Other providers in Logansport, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.