Provider Demographics
NPI:1184063539
Name:CAROL COLE LCSW APC
Entity type:Organization
Organization Name:CAROL COLE LCSW APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCCSW
Authorized Official - Phone:951-506-0560
Mailing Address - Street 1:43218 BUSINESS PARK DR
Mailing Address - Street 2:STE 101
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-3601
Mailing Address - Country:US
Mailing Address - Phone:951-506-0560
Mailing Address - Fax:951-346-9072
Practice Address - Street 1:43218 BUSINESS PARK DR
Practice Address - Street 2:STE 101
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-3601
Practice Address - Country:US
Practice Address - Phone:951-506-0560
Practice Address - Fax:951-346-9072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-19
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS142561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASW14256OtherBOARD OF BEHAVIORAL SCIENCES LICENSE NUMBER