Provider Demographics
NPI:1689119927
Name:COLE, JUDELLIA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:JUDELLIA
Middle Name:
Last Name:COLE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1017 INCA DR
Mailing Address - Street 2:APT D
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-4664
Mailing Address - Country:US
Mailing Address - Phone:504-256-7943
Mailing Address - Fax:
Practice Address - Street 1:650 POYDRAS ST
Practice Address - Street 2:SUITE 1447
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-6101
Practice Address - Country:US
Practice Address - Phone:504-526-4747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-22
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13523104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker