Provider Demographics
NPI:1710016647
Name:COLE, ALISON RENE (LPC)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:RENE
Last Name:COLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:285 S PERRY ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-4840
Mailing Address - Country:US
Mailing Address - Phone:404-844-7621
Mailing Address - Fax:
Practice Address - Street 1:285 S PERRY ST
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046-4840
Practice Address - Country:US
Practice Address - Phone:404-844-7621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2016-02-10
Deactivation Date:2012-10-19
Deactivation Code:
Reactivation Date:2013-02-06
Provider Licenses
StateLicense IDTaxonomies
GALPC005022101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health