Provider Demographics
NPI:1386005932
Name:COLE, JOSEPH III (LISW)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:COLE
Suffix:III
Gender:M
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 ADERLEY OAK CT
Mailing Address - Street 2:
Mailing Address - City:IRMO
Mailing Address - State:SC
Mailing Address - Zip Code:29063-7728
Mailing Address - Country:US
Mailing Address - Phone:803-445-8393
Mailing Address - Fax:
Practice Address - Street 1:52 ADERLEY OAK CT
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-7728
Practice Address - Country:US
Practice Address - Phone:803-445-8393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-10
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC100341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical