Provider Demographics
NPI:1639249220
Name:COLE, LAURA ANN (LMHP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ANN
Last Name:COLE
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 WO BOX 282
Mailing Address - Street 2:
Mailing Address - City:MCCOOL JCT
Mailing Address - State:NE
Mailing Address - Zip Code:68401
Mailing Address - Country:US
Mailing Address - Phone:402-724-3179
Mailing Address - Fax:
Practice Address - Street 1:1100 LINCOLN AV
Practice Address - Street 2:SUITE F
Practice Address - City:YORK
Practice Address - State:NE
Practice Address - Zip Code:68467
Practice Address - Country:US
Practice Address - Phone:402-362-6128
Practice Address - Fax:402-362-7012
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2673101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE47052851582Medicaid
NE47052851507Medicaid
NE85485OtherBCBS#
NE10025208300Medicaid
NE47052851509Medicaid