Provider Demographics
NPI:1861887614
Name:COLEMAN, MICHELLE LYNETTE
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:LYNETTE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:MICHELLE
Other - Middle Name:LYNETTE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4860 S KITTREDGE ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-1718
Mailing Address - Country:US
Mailing Address - Phone:720-298-3125
Mailing Address - Fax:
Practice Address - Street 1:4500 E CHERRY CREEK SOUTH DR
Practice Address - Street 2:SUITE 940
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1518
Practice Address - Country:US
Practice Address - Phone:303-322-7108
Practice Address - Fax:303-322-9989
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health