Healthcare Provider Details

I. General information

NPI: 1700455847
Provider Name (Legal Business Name): ASHLEY NICOLE COLE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2021
Last Update Date: 01/26/2024
Certification Date: 01/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6947 GALLOP DR
CORDOVA TN
38018-2892
US

IV. Provider business mailing address

6947 GALLOP DR
CORDOVA TN
38018-2892
US

V. Phone/Fax

Practice location:
  • Phone: 901-310-7293
  • Fax:
Mailing address:
  • Phone: 901-310-7293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number7255
License Number StateTN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: