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NPI Code Detail

MEDICARE: MICHELE COLEMAN PHD, LMFT

MEDICARE: MICHELE COLEMAN PHD, LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist0084851NM
2103TC1900XCounseling Psychologist0084851NM

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104990845
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELE COLEMAN PHD, LMFT
Provider Business Mailing Address
First Line : 1025 HERMOSA DR SE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-4312
Country : US
Telephone Number : 505-237-0061
Fax Number : 505-237-0068
Provider Business Practice Location Address
First Line : 1025 HERMOSA DR SE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87108-4312
Country : US
Telephone Number : 505-237-0061
Fax Number : 505-237-0068
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2006
Last Update Date : 01/12/2017

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