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General NPI Number Information
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NPI Number | 1770934333
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Entity Type | Individual
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Provider Name | MICHELLE COLEMAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 06/24/2016
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Last Update Date | 06/24/2016
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Provider Practice Location Address
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Address Line | 396 S CENTRE ST 3RD FLOOR
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City | POTTSVILLE
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State | PA
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Zip | 17901-3596
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Country | US
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Telephone | 570-640-3744
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Fax |
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Provider Business Mailing Address
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Address Line | 246 EAST AVE
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City | MOUNT CARMEL
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State | PA
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Zip | 17851-1514
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Country | US
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Telephone | 570-205-8201
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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 | CW018539
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License Number State | PA
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