Provider Demographics
NPI:1467924365
Name:COLEMAN, ERIK MONTEZ
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:MONTEZ
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ENDFIELD ST
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-5651
Mailing Address - Country:US
Mailing Address - Phone:856-340-2991
Mailing Address - Fax:
Practice Address - Street 1:2 ENDFIELD ST
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-5651
Practice Address - Country:US
Practice Address - Phone:856-340-2991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health