MEDICARE: RODNESHIA COLEMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	08289-I	NV

General Provider Information

NPI Number	:	1215866033
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RODNESHIA COLEMAN

Provider Business Mailing Address
First Line	:	10409 CALYPSO CAVE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-8652
Country	:	US
Telephone Number	:	702-348-2141
Fax Number	:

Provider Business Practice Location Address
First Line	:	10409 CALYPSO CAVE ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89141-8652
Country	:	US
Telephone Number	:	702-348-2141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2026
Last Update Date	:	05/18/2026

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Directions to “ RODNESHIA COLEMAN ” Practice Location

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