Provider Demographics
NPI:1184001901
Name:COLEMAN, CHANDRA (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:CHANDRA
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MRS
Other - First Name:CHANDRA
Other - Middle Name:
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8639-B 16TH STREET
Mailing Address - Street 2:284
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910
Mailing Address - Country:US
Mailing Address - Phone:202-768-7133
Mailing Address - Fax:
Practice Address - Street 1:8730 GEORGIA AVE
Practice Address - Street 2:209
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3604
Practice Address - Country:US
Practice Address - Phone:202-768-7133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-30
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3876101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional