Provider Demographics
NPI:1659782001
Name:COLEMAN, ALICIA A (MS, PHD)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:A
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2131 N COLLINS ST STE 433-629
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-2849
Mailing Address - Country:US
Mailing Address - Phone:972-827-8286
Mailing Address - Fax:
Practice Address - Street 1:600 E JOHN CARPENTER FWY STE 287
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75062-4199
Practice Address - Country:US
Practice Address - Phone:972-827-8286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-19
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36577103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical