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General NPI Number Information
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NPI Number | 1356167027
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Entity Type | Individual
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Provider Name | ANTASIA COLEMAN
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Gender | Female
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Dates
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Enumeration Date | 11/27/2024
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 8 FERN RD
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City | SPARTA
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State | NJ
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Zip | 07871-2016
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Country | US
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Telephone | 631-559-3219
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Fax |
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Provider Business Mailing Address
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Address Line | 184 PROSPECT PL
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City | BAY SHORE
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State | NY
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Zip | 11706-1510
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Country | US
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Telephone | 631-559-3219
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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