Individual provider Active NPI

Lacole A Cole, LGPC

  • Mental Health Counselor
  • Waldorf, MD
National Provider Identifier
1831699693
Registry record updated Jan 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LGP8461 Issued in MD
Practice address
3195 Old Washington Rd Ste 110
Waldorf, MD 20602-3201
Phone
(301) 494-4020
Fax
(240) 346-1974
NPI assigned
Feb 19, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LGP8461 MD Primary

Addresses

Primary practice location

3195 Old Washington Rd Ste 110
Waldorf, MD 20602-3201

Mailing address

3375 Malcolm Rd
Brandywine, MD 20613-4029
Phone (240) 346-1974

Other practice location 1

3375 Malcolm Rd
Brandywine, MD 20613-4029
Phone (240) 346-1974

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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

Enrollment IDStateProvider typePAC IDDetails
I20260427001723 MD Practitioner - Mental Health Counselor 8022585140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3195 Old Washington Rd
Suite 110
Waldorf, MD 20602-3201
Phone (301) 494-4020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LGP8461MDMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamic Counseling Group LLC CurrentSince Jan 5, 2020 Accepting new patients

Locations

3195 Old Washington Rd
Ste 110
Waldorf, MD 20602
Phone (240) 346-1974

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1518998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578787200000",
    "number": "1831699693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3375 MALCOLM RD",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206134029",
            "telephone_number": "240-346-1974",
            "fax_number": "301-263-7894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3195 OLD WASHINGTON RD STE 110",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023201",
            "telephone_number": "301-494-4020",
            "fax_number": "240-346-1974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3375 Malcolm Rd",
            "address_purpose": "LOCATION",
            "city": "Brandywine",
            "state": "MD",
            "postal_code": "206134029",
            "country_code": "US",
            "telephone_number": "240-346-1974",
            "fax_number": "240-346-1974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLE",
        "first_name": "LACOLE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "LGPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-19",
        "last_updated": "2020-01-12",
        "certification_date": "2020-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LGP8461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

Verify at the official NPI Registry.