Provider Demographics
NPI:1770062218
Name:COLE, MARY MCKALEIGH (LPC)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:MCKALEIGH
Last Name:COLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1223
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:GA
Mailing Address - Zip Code:30017-0024
Mailing Address - Country:US
Mailing Address - Phone:678-481-5804
Mailing Address - Fax:678-550-9322
Practice Address - Street 1:1350 SCENIC HWY N STE 266
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-7924
Practice Address - Country:US
Practice Address - Phone:678-481-5804
Practice Address - Fax:678-550-9322
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-07
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GALPC011469101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional