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NPI Code Detail

MEDICARE: BRIA TAMIA COLEMAN MSW, LCSWA

MEDICARE: BRIA TAMIA COLEMAN MSW, LCSWA
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
11041C0700XClinical Social WorkerP018646NC

General Provider Information

NPI Number : 1629843404
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIA TAMIA COLEMAN MSW, LCSWA
Provider Business Mailing Address
First Line : 2931 SPRINGSWEET LN APT 24
Second Line :
City : RALEIGH
State : NC
Zip : 27612-7173
Country : US
Telephone Number : 862-766-7748
Fax Number :
Provider Business Practice Location Address
First Line : 2003 E NC HIGHWAY 54 STE C
Second Line :
City : DURHAM
State : NC
Zip : 27713-2483
Country : US
Telephone Number : 919-682-5300
Fax Number : 919-682-5322
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2023
Last Update Date : 11/21/2023

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