Provider Demographics
NPI:1528226131
Name:COLEMAN, JEMMA (LMHC)
Entity Type:Individual
Prefix:
First Name:JEMMA
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 HATHERN LN
Mailing Address - Street 2:
Mailing Address - City:BELLA VISTA
Mailing Address - State:AR
Mailing Address - Zip Code:72714-4509
Mailing Address - Country:US
Mailing Address - Phone:352-225-1436
Mailing Address - Fax:
Practice Address - Street 1:3401 SE MACY RD STE 13
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-7841
Practice Address - Country:US
Practice Address - Phone:479-579-0280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-30
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
FLMH10210101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor