MEDICARE: MS. ARTELIA A COLEMAN MA, CPC

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	101YP2500X	Professional Counselor	2006030215	MO
2	101YP2500X	Professional Counselor	CP0163	NV

General Provider Information

NPI Number	:	1629237623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ARTELIA A COLEMAN MA, CPC

Provider Business Mailing Address
First Line	:	3455 EAGLE BEND ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89122-4741
Country	:	US
Telephone Number	:	314-783-6399
Fax Number	:

Provider Business Practice Location Address
First Line	:	2810 W CHARLESTON BLVD STE 77
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89102-1910
Country	:	US
Telephone Number	:	314-783-6399
Fax Number	:

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

Provider Enumeration Date	:	06/04/2008
Last Update Date	:	05/05/2019

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