Provider Demographics
NPI:1538618749
Name:COLEMAN, STUART ALLAN (MAPC, LPC, MHSP, NCC)
Entity type:Individual
Prefix:
First Name:STUART
Middle Name:ALLAN
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:MAPC, LPC, MHSP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3512 CHRISTENBERRY DRIVE
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37801-2934
Mailing Address - Country:US
Mailing Address - Phone:505-352-4201
Mailing Address - Fax:
Practice Address - Street 1:3512 CHRISTENBERRY DRIVE
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37801-2934
Practice Address - Country:US
Practice Address - Phone:423-408-2601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3669101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health