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General NPI Number Information
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NPI Number | 1639894603
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Entity Type | Organization
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Legal Business Name | COLE COUNSELING, PLLC
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Dates
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Enumeration Date | 10/11/2022
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 103 N 11TH AVE STE 114
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City | SAINT CHARLES
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State | IL
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Zip | 60174-2291
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Country | US
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Telephone | 309-453-9083
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Fax |
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Provider Business Mailing Address
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Address Line | 103 N 11TH AVE STE 114
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City | SAINT CHARLES
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State | IL
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Zip | 60174-2291
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Country | US
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Telephone | 309-453-9083
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | SHERRI GOODMAN
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Credential |
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Telephone | 847-496-0345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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