MEDICARE: TRINETTE HAWKINS COLEMAN

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
1	104100000X	Social Worker
2	171M00000X	Case Manager/Care Coordinator	LC200002183	DC
3	1041C0700X	Clinical Social Worker	LC200002183	DC

General Provider Information

NPI Number	:	1194485631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRINETTE HAWKINS COLEMAN

Provider Business Mailing Address
First Line	:	2722 TIMBERCREST DR
Second Line	:
City	:	FORESTVILLE
State	:	MD
Zip	:	20747-3781
Country	:	US
Telephone Number	:	301-742-4603
Fax Number	:

Provider Business Practice Location Address
First Line	:	2722 TIMBERCREST DR
Second Line	:
City	:	FORESTVILLE
State	:	MD
Zip	:	20747-3781
Country	:	US
Telephone Number	:	301-742-4603
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/25/2021
Last Update Date	:	05/08/2024

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Directions to “ TRINETTE HAWKINS COLEMAN ” Practice Location

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