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General NPI Number Information
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NPI Number | 1386786895
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Entity Type | Organization
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Legal Business Name | JAMES L COLES LCSW, PC
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 02/06/2019
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Provider Practice Location Address
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Address Line | 1 KEUKA BUSINESS PARK
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City | PENN YAN
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State | NY
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Zip | 14527
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Country | US
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Telephone | 716-472-5962
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Fax | 716-387-9696
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Provider Business Mailing Address
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Address Line | 5598 DUTCH ST
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City | DUNDEE
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State | NY
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Zip | 14837-9746
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Country | US
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Telephone | 716-472-5962
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Fax | 716-387-9696
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES LOUIS COLES
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Credential | LCSW
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Telephone | 716-472-5962
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | PR0151101
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | PR00224151
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License Number State | NY
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