David L Cole, LCSW, LPHA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.011051 Issued in IL

Practice address

12 W Harrison St
Sullivan, IL 61951-1907

Phone

(217) 728-4358

Fax

(217) 728-2270

NPI assigned

Feb 4, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Moultrie County Mental Health Center 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Moultrie County Mental Health Center

  • Community/Behavioral Health Agency
  • Sullivan, IL
  • NPI 1811025240

  Clinical, IL

  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233705600000",
    "number": "1164660775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 163",
            "address_2": "12 W. HARRISON",
            "city": "SULLIVAN",
            "state": "IL",
            "postal_code": "619510163",
            "telephone_number": "217-728-4358",
            "fax_number": "217-728-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 W HARRISON ST",
            "city": "SULLIVAN",
            "state": "IL",
            "postal_code": "619511907",
            "telephone_number": "217-728-4358",
            "fax_number": "217-728-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLE",
        "first_name": "DAVID",
        "middle_name": "L",
        "credential": "LCSW, LPHA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-04",
        "last_updated": "2009-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.011051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faisal Bukhari, MD SC
• Patricia E Carr, FNP
• Tabitha Jean Centers, BCBA
• Central Illinois Physical Therapy Professionals, LTD
• Holly Renee Clemons, M.D.
• Community Homecare Inc
• Tatum Copsy, BS
• County of Moultrie
• Cassandra Cox
• Cye Sullivan Hco, LLC

• All providers in Sullivan, IL
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.