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NPI Code Detail

MEDICARE: TRACEY REGINA COLE

MEDICARE:   TRACEY REGINA COLE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164966420
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACEY REGINA COLE
Provider Business Mailing Address
First Line : 6605 COLONY PARK DR
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35243-3348
Country : US
Telephone Number : 314-749-0174
Fax Number :
Provider Business Practice Location Address
First Line : 3296 CAHABA HEIGHTS RD
Second Line :
City : VESTAVIA
State : AL
Zip : 35243-1653
Country : US
Telephone Number : 205-271-2584
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2016
Last Update Date : 12/06/2016

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Directions to “ TRACEY REGINA COLE ” Practice Location

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