Healthcare Provider Details

I. General information

NPI: 1942404116
Provider Name (Legal Business Name): FRANK R COLEMAN LADC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12110 PORT GRACE BLVD STE 101
LA VISTA NE
68128-3190
US

IV. Provider business mailing address

PO BOX 3179
RENO NV
89505-3179
US

V. Phone/Fax

Practice location:
  • Phone: 402-645-0039
  • Fax: 402-925-3936
Mailing address:
  • Phone: 775-232-4141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH00006874
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4455
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number01179-L
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: