Provider Demographics
NPI:1902349525
Name:COLEMAN, VALERIE (MED)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 ELK PL
Mailing Address - Street 2:APT. 1503
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2631
Mailing Address - Country:US
Mailing Address - Phone:678-913-9367
Mailing Address - Fax:
Practice Address - Street 1:3604 CANAL ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-6111
Practice Address - Country:US
Practice Address - Phone:504-822-4333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA731330101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor