Provider Demographics
NPI:1952859100
Name:COLE, ROSS MARSHALL (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:ROSS
Middle Name:MARSHALL
Last Name:COLE
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2305 FONTAINE CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-4418
Mailing Address - Country:US
Mailing Address - Phone:425-890-3080
Mailing Address - Fax:
Practice Address - Street 1:2307 WILKINSON BLVD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-5611
Practice Address - Country:US
Practice Address - Phone:980-250-5767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-16
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0119511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical