Provider Demographics
NPI:1326353640
Name:COLEMAN CHILD AND ADOLESCENT ASSESSMENT INC.
Entity Type:Organization
Organization Name:COLEMAN CHILD AND ADOLESCENT ASSESSMENT INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:773-501-5919
Mailing Address - Street 1:600 N WOODSTONE DR
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:KS
Mailing Address - Zip Code:67002-9318
Mailing Address - Country:US
Mailing Address - Phone:316-733-4727
Mailing Address - Fax:
Practice Address - Street 1:833 N WACO AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-3989
Practice Address - Country:US
Practice Address - Phone:316-263-2351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1788103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty