Provider Demographics
NPI:1487254371
Name:COLEMAN, TAMARA ROCHELLE (LSCW)
Entity type:Individual
Prefix:
First Name:TAMARA
Middle Name:ROCHELLE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LSCW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 WASHINGTON ST STE 16
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23704-3508
Mailing Address - Country:US
Mailing Address - Phone:757-769-0070
Mailing Address - Fax:
Practice Address - Street 1:500 WASHINGTON ST STE 16
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-3508
Practice Address - Country:US
Practice Address - Phone:757-769-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional