Provider Demographics
NPI:1194059105
Name:COLE, PETER HAYS (LCSW)
Entity type:Individual
Prefix:MR
First Name:PETER
Middle Name:HAYS
Last Name:COLE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 P ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95811-5225
Mailing Address - Country:US
Mailing Address - Phone:916-444-1786
Mailing Address - Fax:916-553-4373
Practice Address - Street 1:2011 P ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95811-5225
Practice Address - Country:US
Practice Address - Phone:916-444-1786
Practice Address - Fax:916-553-4373
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS151541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical