Provider Demographics
NPI:1568032126
Name:COLEMAN, JOHN JR (LPC, LCAS)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:
Last Name:COLEMAN
Suffix:JR
Gender:M
Credentials:LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 DAVIS DR
Mailing Address - Street 2:
Mailing Address - City:LOUISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27549-8962
Mailing Address - Country:US
Mailing Address - Phone:919-332-9341
Mailing Address - Fax:
Practice Address - Street 1:144 DAVIS DR
Practice Address - Street 2:
Practice Address - City:LOUISBURG
Practice Address - State:NC
Practice Address - Zip Code:27549-8962
Practice Address - Country:US
Practice Address - Phone:919-332-9341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)