Provider Demographics
NPI:1215761945
Name:COLE, KATHERINE (CADC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:COLE
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1223 CENTER ST STE 22
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50309-1016
Mailing Address - Country:US
Mailing Address - Phone:515-218-6125
Mailing Address - Fax:
Practice Address - Street 1:1223 CENTER ST STE 22
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-1016
Practice Address - Country:US
Practice Address - Phone:515-218-6125
Practice Address - Fax:515-244-5687
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)