Provider Demographics
NPI:1518690809
Name:COLTER, JAMES LEE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:LEE
Last Name:COLTER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 5TH AVE # 1539
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018-2794
Mailing Address - Country:US
Mailing Address - Phone:347-564-1478
Mailing Address - Fax:
Practice Address - Street 1:926 MADISON ST APT 3B
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11221-5444
Practice Address - Country:US
Practice Address - Phone:347-564-1478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-05
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0923911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical