Healthcare Provider Details

I. General information

NPI: 1073913190
Provider Name (Legal Business Name): COLEMAN COUNSELING, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2014
Last Update Date: 08/26/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 NW 3RD ST
EAGLE GROVE IA
50533-1308
US

IV. Provider business mailing address

321 NW 3RD ST
EAGLE GROVE IA
50533-1308
US

V. Phone/Fax

Practice location:
  • Phone: 515-368-0150
  • Fax: 515-448-9008
Mailing address:
  • Phone: 515-368-0150
  • Fax: 515-448-9008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. JILL COLEMAN
Title or Position: DIRECTOR
Credential:
Phone: 515-368-0150