MEDICARE: CAROL COLEMAN LCSW

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	44SL05865500	NJ
2	1041C0700X	Clinical Social Worker	44SC06051200	NJ

General Provider Information

NPI Number	:	1790191930
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROL COLEMAN LCSW

Provider Business Mailing Address
First Line	:	2333 MORRIS AVE STE C206
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-5739
Country	:	US
Telephone Number	:	908-291-2727
Fax Number	:

Provider Business Practice Location Address
First Line	:	2333 MORRIS AVE STE C206
Second Line	:
City	:	UNION
State	:	NJ
Zip	:	07083-5739
Country	:	US
Telephone Number	:	908-291-2727
Fax Number	:

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

Provider Enumeration Date	:	07/09/2014
Last Update Date	:	07/08/2024

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Directions to “ CAROL COLEMAN LCSW” Practice Location

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