Keisha Davell Cole, CREDENTIALING MANAGE

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2259 W Taylor St
Chicago, IL 60612-4233

Phone

(312) 285-2982

NPI assigned

Apr 28, 2020

Last updated

Aug 24, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ear to Ear Behavioral Health Solutions

  • Adult Mental Health Clinic/Center
  • Chicago, IL
  • NPI 1467023150
  NPD
• Sunshine Psychiatry LTD

  • Psychiatric/Mental Health Nurse Practitioner
  • Chicago, IL
  • NPI 1619662442
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629763200000",
    "number": "1154942449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2259 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124233",
            "telephone_number": "312-285-2982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2259 W TAYLOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124233",
            "telephone_number": "312-285-2982"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "KEISHA",
        "middle_name": "DAVELL",
        "credential": "CREDENTIALING MANAGE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-28",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Cole
• Joanna Cole
• John Tyler Cole, PA-C
• Julie Kirby Cole, LCSW
• Karston Cole, MS, LCPC, LASOP
• Keith Robert Cole, DPT
• Kimberly Sharon Cole, M.D.
• Kyle Anthony Cole, MD
• Latonya Cole
• Latoya Cole

• Mental Health Counselor in Chicago, IL
• Providers in Chicago, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.