Provider Demographics
NPI:1285191965
Name:COLE-SCOTT, CONSTANCE MICHELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:MICHELLE
Last Name:COLE-SCOTT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3803 BOULDER DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75233-3114
Mailing Address - Country:US
Mailing Address - Phone:972-502-4020
Mailing Address - Fax:
Practice Address - Street 1:3803 BOULDER DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75233-3114
Practice Address - Country:US
Practice Address - Phone:972-502-4020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2019-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX572261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical