Provider Demographics
NPI:1093893398
Name:COLEMAN, RENATA (LSCSW)
Entity Type:Individual
Prefix:MS
First Name:RENATA
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2055 SW CLAY ST
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-3078
Mailing Address - Country:US
Mailing Address - Phone:785-234-5663
Mailing Address - Fax:785-234-4853
Practice Address - Street 1:2055 SW CLAY ST
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-3078
Practice Address - Country:US
Practice Address - Phone:785-234-5663
Practice Address - Fax:785-234-4853
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS35551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical