Provider Demographics
NPI:1700185063
Name:COLEMAN, LOLA C (LCSW-BACS)
Entity type:Individual
Prefix:MRS
First Name:LOLA
Middle Name:C
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LCSW-BACS
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 7131
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71211-7131
Mailing Address - Country:US
Mailing Address - Phone:318-614-6380
Mailing Address - Fax:318-345-0117
Practice Address - Street 1:501 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:DELHI
Practice Address - State:LA
Practice Address - Zip Code:71232-3001
Practice Address - Country:US
Practice Address - Phone:318-878-8656
Practice Address - Fax:318-878-2831
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA40941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical