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Organization
KELLY COLE LICENSED CLINICAL SOCIAL WORKER INC
Active
Organization
KELLY COLE LICENSED CLINICAL SOCIAL WORKER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY COLE (OWNER)
(707) 599-2856
Entity
Organization
Contact information
Practice address
655 F ST STE A, ARCATA, CA 95521-6366
(707) 599-2856
Mailing address
PO BOX 1123, TRINIDAD, CA 95570-1123
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Enumeration date
06/02/2022
Last updated
04/10/2024
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