MEDICARE: HUGH LIVINGSTON COLE III LCSW

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	28068	IL
2	1041C0700X	Clinical Social Worker	149022364	IL
3	1041C0700X	Clinical Social Worker	149018354	IL

General Provider Information

NPI Number	:	1346681350
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUGH LIVINGSTON COLE III LCSW

Provider Business Mailing Address
First Line	:	7637 N BOSWORTH AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-7159
Country	:	US
Telephone Number	:	773-334-3533
Fax Number	:	888-940-2010

Provider Business Practice Location Address
First Line	:	4809 N RAVENSWOOD AVE UNIT 210
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-4417
Country	:	US
Telephone Number	:	773-334-3533
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/08/2013
Last Update Date	:	07/31/2025

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