Healthcare Provider Details

I. General information

NPI: 1912371741
Provider Name (Legal Business Name): SOLANGE D COLE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/17/2015
Last Update Date: 12/29/2021
Certification Date: 12/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4878 FINLAY ST
HENRICO VA
23231-2810
US

IV. Provider business mailing address

4878 FINLAY ST
HENRICO VA
23231-2810
US

V. Phone/Fax

Practice location:
  • Phone: 804-922-3740
  • Fax: 904-222-3737
Mailing address:
  • Phone: 804-922-3740
  • Fax: 804-222-3737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number0904009223
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: