MEDICARE: COLE ANDREW CHARRON LPC, LMHP

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	101YM0800X	Mental Health Counselor	10298	NE
2	101YP2500X	Professional Counselor	P2601002	AR

General Provider Information

NPI Number	:	1629484035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLE ANDREW CHARRON LPC, LMHP

Provider Business Mailing Address
First Line	:	5 CHUDLEIGH LN
Second Line	:
City	:	BELLA VISTA
State	:	AR
Zip	:	72714-3135
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2113 S 54TH ST STE 5
Second Line	:
City	:	ROGERS
State	:	AR
Zip	:	72758-8169
Country	:	US
Telephone Number	:	479-903-0070
Fax Number	:

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

Provider Enumeration Date	:	07/07/2014
Last Update Date	:	03/03/2026

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