MEDICARE: COLE RISBON LPC, NCC

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	101YP2500X	Professional Counselor	PC018971	PA

General Provider Information

NPI Number	:	1700543667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COLE RISBON LPC, NCC

Provider Business Mailing Address
First Line	:	11676 PERRY HWY STE 2105
Second Line	:
City	:	WEXFORD
State	:	PA
Zip	:	15090-7200
Country	:	US
Telephone Number	:	878-283-2636
Fax Number	:	412-588-1266

Provider Business Practice Location Address
First Line	:	11676 PERRY HWY STE 2105
Second Line	:
City	:	WEXFORD
State	:	PA
Zip	:	15090-7200
Country	:	US
Telephone Number	:	878-283-2636
Fax Number	:	412-588-1266

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

Provider Enumeration Date	:	11/25/2021
Last Update Date	:	02/03/2026

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