Provider Demographics
NPI:1780905653
Name:COLEE, CIRI HALEY (MED, MDIV, LPC, CAC)
Entity type:Individual
Prefix:MS
First Name:CIRI
Middle Name:HALEY
Last Name:COLEE
Suffix:
Gender:F
Credentials:MED, MDIV, LPC, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:671 BUCKHALL CT
Mailing Address - Street 2:
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3569
Mailing Address - Country:US
Mailing Address - Phone:843-814-3348
Mailing Address - Fax:
Practice Address - Street 1:207 LUCAS STREET
Practice Address - Street 2:SUITE D-1
Practice Address - City:MT. PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464
Practice Address - Country:US
Practice Address - Phone:843-814-3348
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0909292101YA0400X
SC2801101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)