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General NPI Number Information
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NPI Number | 1700011079
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Entity Type | Individual
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Provider Name | TONYA H COLEMAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/15/2009
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Last Update Date | 06/13/2016
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Provider Practice Location Address
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Address Line | 6220 THERMAL RD
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City | CHARLOTTE
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State | NC
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Zip | 28211-5630
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Country | US
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Telephone | 704-366-8712
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Fax |
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Provider Business Mailing Address
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Address Line | 5654 KIMMERLY WOODS DR
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City | CHARLOTTE
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State | NC
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Zip | 28215-4244
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Country | US
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Telephone | 980-335-1098
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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 | LC50078582
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License Number State | DC
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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 | 14920
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License Number State | MD
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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 | C008556
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License Number State | NC
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