Cristal Lynn Cook, LCSW

Individual provider Active NPI Clinical Social Worker · Mancos, CO

NPI 1508856451 · NPPES record last updated Dec 16, 2022

Key facts

NPI
1508856451
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
306 (CO)
Practice address
459 Bauer Avenue
Mancos, CO 81328
Phone
(720) 710-6472
NPI assigned
Oct 24, 2005
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

State licenses

LicenseStateTypeSpecialty
C053700518CAMDAddiction (Substance Use Disorder) Counselor
LCSW-20768AZMDClinical Social Worker
306COMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X C053700518 CA
Clinical Social Worker 1041C0700X LCSW-20768 AZ
Clinical Social Worker 1041C0700X 306 CO Yes

Addresses

Primary practice location

459 Bauer Avenue
Mancos, CO 81328

Mailing address

PO Box 539
Mancos, CO 81328-0539
Phone (720) 710-6472

Other providers in Mancos, CO

All providers in Mancos, CO · Clinical Social Worker in Colorado

Sources for this page

Verify at the official NPI Registry.