Provider Demographics
NPI:1083989370
Name:COLEMAN, DARRELL (LCSW-C)
Entity Type:Individual
Prefix:MR
First Name:DARRELL
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 PENN BELT PL
Mailing Address - Street 2:
Mailing Address - City:DISTRICT HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20747-4734
Mailing Address - Country:US
Mailing Address - Phone:301-276-5312
Mailing Address - Fax:
Practice Address - Street 1:3900 PENN BELT PL
Practice Address - Street 2:
Practice Address - City:DISTRICT HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20747-4734
Practice Address - Country:US
Practice Address - Phone:301-276-5312
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-20
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0066301041C0700X
MD193781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical