Provider Demographics
NPI:1992895270
Name:COLE, SUSAN ELIZABETH
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ELIZABETH
Last Name:COLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 FRANKLIN ST
Mailing Address - Street 2:UNIT C-1
Mailing Address - City:WHITMAN
Mailing Address - State:MA
Mailing Address - Zip Code:02382-2551
Mailing Address - Country:US
Mailing Address - Phone:781-635-2156
Mailing Address - Fax:
Practice Address - Street 1:185 MAIN ST
Practice Address - Street 2:SUITE 28
Practice Address - City:AVON
Practice Address - State:MA
Practice Address - Zip Code:02322-1452
Practice Address - Country:US
Practice Address - Phone:781-635-2156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health