MEDICARE: BENJAMIN COLE

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	260820	KY

General Provider Information

NPI Number	:	1811476278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BENJAMIN COLE

Provider Business Mailing Address
First Line	:	611 FOREST AVE
Second Line	:
City	:	MAYSVILLE
State	:	KY
Zip	:	41056-1411
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 THOMAS MORE PKWY STE 160
Second Line	:
City	:	CRESTVIEW HILLS
State	:	KY
Zip	:	41017-5460
Country	:	US
Telephone Number	:	859-600-6990
Fax Number	:

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

Provider Enumeration Date	:	08/07/2018
Last Update Date	:	06/19/2026

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Directions to “ BENJAMIN COLE ” Practice Location

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