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General NPI Number Information
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NPI Number | 1528307139
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Entity Type | Individual
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Provider Name | WELLINGTON JOHN COLEMAN JR. PH.D.
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Gender | Male
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Dates
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Enumeration Date | 02/04/2013
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Last Update Date | 05/08/2023
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Provider Practice Location Address
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Address Line | 4301 ELYSIAN FIELDS AVE STE 100
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City | NEW ORLEANS
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State | LA
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Zip | 70122-7400
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Country | US
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Telephone | 504-813-1283
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Fax | 504-246-2373
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Provider Business Mailing Address
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Address Line | 3308 TULANE AVE SUITE 304
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City | NEW ORLEANS
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State | LA
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Zip | 70119
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Country | US
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Telephone | 504-354-2090
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Fax | 504-354-2090
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LA.2651
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License Number State |
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