Provider Demographics
NPI:1154728723
Name:COLE, HERBERT (LPC, MA, NCC)
Entity type:Individual
Prefix:MR
First Name:HERBERT
Middle Name:
Last Name:COLE
Suffix:
Gender:M
Credentials:LPC, MA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8046 ROSWELL RD STE 101C
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-3930
Mailing Address - Country:US
Mailing Address - Phone:770-833-6052
Mailing Address - Fax:877-262-0792
Practice Address - Street 1:1220 WITHAM DR
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-3335
Practice Address - Country:US
Practice Address - Phone:770-833-6052
Practice Address - Fax:877-262-0792
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-26
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC007257101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional