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General NPI Number Information
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NPI Number | 1841336286
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Entity Type | Individual
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Provider Name | BERNICE COLEMAN LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5 WEST 86TH STREET SUITE #1D
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City | NEW YORK
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State | NY
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Zip | 10024
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Country | US
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Telephone | 212-262-0264
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Fax |
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Provider Business Mailing Address
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Address Line | 380 MOUNTAIN ROAD #1906
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City | UNION CITY
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State | NJ
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Zip | 07087
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Country | US
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Telephone | 201-330-0521
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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 | R0163531
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License Number State | NY
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