MEDICARE: TINA COLE MSW, LISW-S

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	1041C0700X	Clinical Social Worker	I-028336-SUPV	OH

General Provider Information

NPI Number	:	1538014261
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TINA COLE MSW, LISW-S

Provider Business Mailing Address
First Line	:	381 WOODMARK RUN
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43230-5029
Country	:	US
Telephone Number	:	614-477-3323
Fax Number	:

Provider Business Practice Location Address
First Line	:	381 WOODMARK RUN
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43230-5029
Country	:	US
Telephone Number	:	614-477-3323
Fax Number	:

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

Provider Enumeration Date	:	02/27/2026
Last Update Date	:	02/27/2026

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