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General NPI Number Information
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NPI Number | 1548542236
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Entity Type | Individual
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Provider Name | MEGHAN RENEE COLE LPC, CSAC
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Gender | Female
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Dates
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Enumeration Date | 09/19/2011
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Last Update Date | 12/14/2011
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Provider Practice Location Address
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Address Line | 1020 S MAIN ST
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City | FOND DU LAC
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State | WI
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Zip | 54935-6138
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Country | US
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Telephone | 920-923-9054
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Fax | 920-322-9193
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Provider Business Mailing Address
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Address Line | 1020 S MAIN ST
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City | FOND DU LAC
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State | WI
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Zip | 54935-6138
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Country | US
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Telephone | 920-923-9054
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Fax | 920-322-9193
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 15578-132
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 4527-125
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License Number State | WI
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