Healthcare Provider Details

I. General information

NPI: 1639249220
Provider Name (Legal Business Name): LAURA ANN COLE LMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 LINCOLN AV SUITE F
YORK NE
68467
US

IV. Provider business mailing address

220 WO BOX 282
MCCOOL JCT NE
68401
US

V. Phone/Fax

Practice location:
  • Phone: 402-362-6128
  • Fax: 402-362-7012
Mailing address:
  • Phone: 402-724-3179
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2673
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: