Provider Demographics
NPI:1588651483
Name:COLEMAN, MICHELLE S (LPC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:S
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11415 HURON LN UNIT 22205
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72221-7125
Mailing Address - Country:US
Mailing Address - Phone:501-588-7800
Mailing Address - Fax:
Practice Address - Street 1:4 SHACKLEFORD PLZ STE 202A
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-1844
Practice Address - Country:US
Practice Address - Phone:501-588-7800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11619101YP2500X
NJ37PC00883200101YP2500X
ARP0501002101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5Y519OtherBLUE CROSS BLUE SHIELD