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General NPI Number Information
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NPI Number | 1831699693
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Entity Type | Individual
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Provider Name | LACOLE A COLE LGPC
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Gender | Female
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Dates
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Enumeration Date | 02/19/2018
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Last Update Date | 01/12/2020
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Provider Practice Location Address
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Address Line | 3195 OLD WASHINGTON RD STE 110
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City | WALDORF
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State | MD
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Zip | 20602-3201
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Country | US
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Telephone | 301-494-4020
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Fax | 240-346-1974
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Provider Business Mailing Address
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Address Line | 3375 MALCOLM RD
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City | BRANDYWINE
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State | MD
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Zip | 20613-4029
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Country | US
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Telephone | 240-346-1974
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Fax | 301-263-7894
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LGP8461
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License Number State | MD
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