Healthcare Provider Details

I. General information

NPI: 1871404384
Provider Name (Legal Business Name): CHRISTOPHER COLEMAN MA LPCC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 COUNTY ROAD 10 NE STE 200
BLAINE MN
55434-2373
US

IV. Provider business mailing address

607 COUNTY ROAD 10 NE STE 200
BLAINE MN
55434-2373
US

V. Phone/Fax

Practice location:
  • Phone: 320-465-1869
  • Fax:
Mailing address:
  • Phone: 320-465-1869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5858
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: