Provider Demographics
NPI:1023571338
Name:COLEMAN, VERNAIZE K (LMHC)
Entity Type:Individual
Prefix:PROF
First Name:VERNAIZE
Middle Name:K
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2569 ADAM CLAYTON POWELL JR BLVD APT 22L
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10039-3229
Mailing Address - Country:US
Mailing Address - Phone:646-234-2305
Mailing Address - Fax:
Practice Address - Street 1:1775 GRAND CONCOURSE # 8TH
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-8202
Practice Address - Country:US
Practice Address - Phone:212-560-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-12
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP03841101YM0800X
NY011048-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty