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NPI Code Detail

MEDICARE: RYAN K COLE LCSW

MEDICARE:   RYAN K COLE  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
11041C0700XClinical Social WorkerLC16929ME

General Provider Information

NPI Number : 1801272463
Entity Type Code : Individual
Provider Name (Legal Business Name) : RYAN K COLE LCSW
Provider Business Mailing Address
First Line : 50 MOODY ST
Second Line : SWEETSER
City : SACO
State : ME
Zip : 04072-1536
Country : US
Telephone Number : 800-434-3000
Fax Number :
Provider Business Practice Location Address
First Line : 217 MAIN ST
Second Line :
City : LEWISTON
State : ME
Zip : 04240-7069
Country : US
Telephone Number : 800-434-3000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2015
Last Update Date : 04/04/2022

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Directions to “ RYAN K COLE LCSW” Practice Location

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