Provider Demographics
NPI:1194551523
Name:SZABO, COLE (LADAC II)
Entity type:Individual
Prefix:
First Name:COLE
Middle Name:
Last Name:SZABO
Suffix:
Gender:M
Credentials:LADAC II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7997 HAMPTON COVE DR
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-7184
Mailing Address - Country:US
Mailing Address - Phone:234-380-7214
Mailing Address - Fax:
Practice Address - Street 1:7997 HAMPTON COVE DR
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-7184
Practice Address - Country:US
Practice Address - Phone:234-380-7214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1338101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)