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General NPI Number Information
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NPI Number | 1184781221
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Entity Type | Individual
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Provider Name | TYLER B COLEMAN MA, LCPC, LAC
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Gender | Female
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Dates
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Enumeration Date | 01/01/2007
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 2825 STOCKYARD RD STE A22
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City | MISSOULA
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State | MT
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Zip | 59808-1546
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Country | US
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Telephone | 406-396-5910
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Fax |
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Provider Business Mailing Address
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Address Line | 1107 LINCOLNWOOD RD
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City | MISSOULA
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State | MT
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Zip | 59802-3037
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Country | US
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Telephone | 406-396-5910
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 664
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1041
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License Number State | MT
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