Provider Demographics
NPI:1194884163
Name:COLE HALL, TIFFANY (CSW, CADC)
Entity type:Individual
Prefix:MRS
First Name:TIFFANY
Middle Name:
Last Name:COLE HALL
Suffix:
Gender:F
Credentials:CSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8605 CODINGTON CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-1012
Mailing Address - Country:US
Mailing Address - Phone:502-592-5009
Mailing Address - Fax:502-582-0905
Practice Address - Street 1:1556 N OLD HIGHWAY 135
Practice Address - Street 2:
Practice Address - City:CORYDON
Practice Address - State:IN
Practice Address - Zip Code:47112-2002
Practice Address - Country:US
Practice Address - Phone:812-738-3277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-48901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical