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NPI Code Detail

MEDICARE: DEBORAH COLE LCPC

MEDICARE: DEBORAH COLE LCPC
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
1101YM0800XMental Health CounselorCC124ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RB9OTHERMEANTHEM

General Provider Information

NPI Number : 1801985361
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH COLE LCPC
Provider Business Mailing Address
First Line : 899 RIVERSIDE ST
Second Line :
City : PORTLAND
State : ME
Zip : 04103-1070
Country : US
Telephone Number : 207-871-1200
Fax Number : 207-871-1232
Provider Business Practice Location Address
First Line : 17 BISHOP ST
Second Line :
City : PORTLAND
State : ME
Zip : 04103-2659
Country : US
Telephone Number : 207-871-1234
Fax Number : 207-871-6161
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 07/09/2007

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