| James L Coles Lcsw, Pc | |
|
1 Keuka Business Park Penn Yan NY 14527 | |
| (716) 472-5962 | |
| (716) 387-9696 |
| Full Name | James L Coles Lcsw, Pc |
|---|---|
| Speciality | Social Worker |
| Location | 1 Keuka Business Park, Penn Yan, New York |
| Authorized Official Name and Position | James Louis Coles (PRESIDENT) |
| Authorized Official Contact | 7164725962 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| James L Coles Lcsw, Pc 5598 Dutch St Dundee NY 14837-9746 Ph: (716) 472-5962 | James L Coles Lcsw, Pc 1 Keuka Business Park Penn Yan NY 14527 Ph: (716) 472-5962 |
| NPI Number | 1386786895 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 02/06/2019 |
| Medicare PECOS PAC ID | 7719221712 |
|---|---|
| Medicare Enrollment ID | O20181203000613 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386786895 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | PR00224151 (New York) | Primary |
| 104100000X | Social Worker | PR0151101 (New York) | Secondary |
| Provider Name | Carol A Coles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215061189 PECOS PAC ID: 6002821501 Enrollment ID: I20060220000256 |
Soldiers & Sailors Hospital Psych Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 418 N Main St, Penn Yan, NY 14527 Phone: 315-787-4150 Fax: 315-787-4794 |