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General NPI Number Information
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NPI Number | 1154027050
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Entity Type | Individual
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Provider Name | CAMILLE COLEMAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/01/2023
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 5441 S MACADAM AVE # 8112
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City | PORTLAND
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State | OR
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Zip | 97239-6106
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Country | US
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Telephone | 503-298-5722
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Fax |
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Provider Business Mailing Address
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Address Line | 3507 NE 12TH AVE
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City | PORTLAND
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State | OR
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Zip | 97212-2250
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Country | US
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Telephone | 971-678-7008
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 150109749
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | A14365
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | L16312
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License Number State | OR
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