Provider Demographics
NPI:1124179023
Name:COLE, CAROLYN ANN (LPC,LBSW,LCDC)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:ANN
Last Name:COLE
Suffix:
Gender:F
Credentials:LPC,LBSW,LCDC
Other - Prefix:MS
Other - First Name:CAROLYN
Other - Middle Name:ANN
Other - Last Name:LAWSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC,LBSW,LCDC
Mailing Address - Street 1:1606 MISSOURI AVE
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76541-9075
Mailing Address - Country:US
Mailing Address - Phone:254-690-4988
Mailing Address - Fax:
Practice Address - Street 1:DEPARTMENT OF SUBSTANCE ABUSE
Practice Address - Street 2:BLD 2245
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-287-2892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4974101YA0400X
TX15091104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker