Provider Demographics
NPI:1609277284
Name:COLEMAN, YANNIQUEGAIL (LMSW)
Entity Type:Individual
Prefix:
First Name:YANNIQUEGAIL
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10206 FARMERS BLVD
Mailing Address - Street 2:
Mailing Address - City:HOLLIS
Mailing Address - State:NY
Mailing Address - Zip Code:11423-3126
Mailing Address - Country:US
Mailing Address - Phone:718-454-6349
Mailing Address - Fax:
Practice Address - Street 1:10206 FARMERS BLVD
Practice Address - Street 2:
Practice Address - City:HOLLIS
Practice Address - State:NY
Practice Address - Zip Code:11423-3126
Practice Address - Country:US
Practice Address - Phone:718-454-6349
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-15
Last Update Date:2014-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY081544-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker