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NPI Code Detail

MEDICARE: KAYCEE COLEMAN

MEDICARE: KAYCEE 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
11041C0700XClinical Social WorkerLCSW-23157AZ

General Provider Information

NPI Number : 1811678501
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYCEE COLEMAN
Provider Business Mailing Address
First Line : 3045 E CORRINE DR
Second Line :
City : PHOENIX
State : AZ
Zip : 85032-6551
Country : US
Telephone Number : 520-975-7114
Fax Number :
Provider Business Practice Location Address
First Line : 4612 N 28TH ST
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-4931
Country : US
Telephone Number : 520-975-7114
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2023
Last Update Date : 01/05/2026

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Directions to “ KAYCEE COLEMAN ” Practice Location

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