MEDICARE: MS. SUSAN ELIZABETH 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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1992895270
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SUSAN ELIZABETH COLE

Provider Business Mailing Address
First Line	:	100 FRANKLIN ST
Second Line	:	UNIT C-1
City	:	WHITMAN
State	:	MA
Zip	:	02382-2551
Country	:	US
Telephone Number	:	781-635-2156
Fax Number	:

Provider Business Practice Location Address
First Line	:	185 MAIN ST
Second Line	:	SUITE 28
City	:	AVON
State	:	MA
Zip	:	02322-1452
Country	:	US
Telephone Number	:	781-635-2156
Fax Number	:

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

Provider Enumeration Date	:	10/15/2006
Last Update Date	:	07/08/2007

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