Provider Demographics
NPI:1598131377
Name:MITCHELL-COLES, TAMMYE LYNNE (LPC)
Entity Type:Individual
Prefix:MS
First Name:TAMMYE
Middle Name:LYNNE
Last Name:MITCHELL-COLES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:616 GAINSBOROUGH DR
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-1948
Mailing Address - Country:US
Mailing Address - Phone:517-974-1932
Mailing Address - Fax:517-332-4731
Practice Address - Street 1:616 GAINSBOROUGH DRIVE
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823
Practice Address - Country:US
Practice Address - Phone:517-974-1932
Practice Address - Fax:517-332-4731
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-17
Last Update Date:2019-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401001192101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional