Individual
COLE IVANCIC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
3709 N LOCUST GROVE RD STE 100, MERIDIAN, ID 83646-5924
(208) 860-2598
Mailing address
3709 N LOCUST GROVE RD STE 100, MERIDIAN, ID 83646-5924
(208) 860-2598
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
8911012
ID
Other
Enumeration date
05/26/2022
Last updated
10/15/2025
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