Provider Demographics
NPI:1538549621
Name:COLEMAN, LINDA (PLPC)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 762
Mailing Address - Street 2:SUITE N
Mailing Address - City:AMITE
Mailing Address - State:LA
Mailing Address - Zip Code:70422-0762
Mailing Address - Country:US
Mailing Address - Phone:985-474-5455
Mailing Address - Fax:985-284-7077
Practice Address - Street 1:1011 NW CENTRAL AVENUE
Practice Address - Street 2:SUITE N
Practice Address - City:AMITE
Practice Address - State:LA
Practice Address - Zip Code:70422
Practice Address - Country:US
Practice Address - Phone:985-474-5455
Practice Address - Fax:985-284-7077
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4455101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health