Healthcare Provider Details

I. General information

NPI: 1992193361
Provider Name (Legal Business Name): LAUREN E COLES LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2015
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 N 20TH PL STE 1
ROGERS AR
72756-3571
US

IV. Provider business mailing address

323 HOMEWOOD PL
LOWELL AR
72745-9336
US

V. Phone/Fax

Practice location:
  • Phone: 479-274-8271
  • Fax:
Mailing address:
  • Phone: 479-365-0921
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberP1704282
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA1501012
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: