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General NPI Number Information
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NPI Number | 1194307389
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Entity Type | Individual
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Provider Name | KELLY SCOTT COLEMAN LMSW-C, MSW, CAADC
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Gender | Male
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Dates
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Enumeration Date | 04/27/2021
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 1009 WASHINGTON AVE
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City | BAY CITY
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State | MI
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Zip | 48708-5705
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Country | US
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Telephone | 989-928-3566
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Fax |
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Provider Business Mailing Address
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Address Line | 1020 N 26TH ST
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City | SAGINAW
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State | MI
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Zip | 48601-6115
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Country | US
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Telephone | 989-529-4000
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State | MI
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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 | 6851109700
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License Number State | MI
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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 | 6801120277
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License Number State | MI
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