Healthcare Provider Details

I. General information

NPI: 1831245588
Provider Name (Legal Business Name): TIFFANY KIM COLE LPC, CAC II
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 12/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4141 E DICKENSON PL
DENVER CO
80222-6012
US

IV. Provider business mailing address

4141 E DICKENSON PL
DENVER CO
80222-6012
US

V. Phone/Fax

Practice location:
  • Phone: 303-504-1003
  • Fax: 303-321-1040
Mailing address:
  • Phone: 303-504-1003
  • Fax: 303-321-1040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number5114
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: