Carolyn Lacy Cook, MA, LPC
Individual provider Active NPI Counseling Psychologist · Monona, WI
NPI 1700890258 · NPPES record last updated Mar 5, 2024
Key facts
- NPI
- 1700890258
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counseling Psychologist 103TC1900X
- License
- 5639-125 (WI)
- Practice address
- 1532 W Broadway Ste 201
Monona, WI 53713-1828 - Phone
- (608) 223-1506
- NPI assigned
- Jul 28, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5639-125 | WI | MD | Counseling Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Living Well Counseling Services LLC | Mental Health | Current |
Accepting new patients |
Locations
1532 W Broadway
Ste 201
Monona, WI 53713
Phone (608) 223-1506
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 5639-125 | WI | Yes |
Addresses
Primary practice location
1532 W Broadway Ste 201
Monona, WI 53713-1828
Mailing address
1532 W Broadway Ste 201
Monona, WI 53713-1828
Phone (608) 223-1506
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- Susan Cooper
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All providers in Monona, WI · Counseling Psychologist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2024. 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.