Provider Demographics
NPI:1114312188
Name:COLEMAN, SHELLEY (LPC)
Entity Type:Individual
Prefix:DR
First Name:SHELLEY
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LPC
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 69
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-0069
Mailing Address - Country:US
Mailing Address - Phone:681-235-2169
Mailing Address - Fax:681-235-2126
Practice Address - Street 1:153 LOWER OVERLOOK DR
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9023
Practice Address - Country:US
Practice Address - Phone:304-399-6842
Practice Address - Fax:304-526-2638
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-06
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2172101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional