Individual
DR. JONATHAN D COLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
BLUEGRASS HEALTH PSYCHOLOGY, INC., 2220 YOUNG DRIVE, LEXINGTON, KY 40505-4219
(859) 277-1008
(859) 277-1083
Mailing address
BLUEGRASS HEALTH PSYCHOLOGY, INC., 4101 TATES CREEK CTR DR STE 150, PMB 123, LEXINGTON, KY 40517-3066
(859) 277-1008
(859) 277-1083
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
1200
KY
103TC0700X
Clinical Psychologist
Primary
128960
KY
103TH0004X
Health Psychologist
1200
KY
103TH0004X
Health Psychologist
128960
KY
103TH0100X
Health Service Psychologist
1200
KY
103TH0100X
Health Service Psychologist
128960
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89000749
—
KY
Enumeration date
09/25/2006
Last updated
11/18/2020
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