Provider Demographics
NPI:1700011079
Name:COLEMAN, TONYA H (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:H
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:TONYA
Other - Middle Name:N
Other - Last Name:HART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:5654 KIMMERLY WOODS DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28215-4244
Mailing Address - Country:US
Mailing Address - Phone:980-335-1098
Mailing Address - Fax:
Practice Address - Street 1:6220 THERMAL RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-5630
Practice Address - Country:US
Practice Address - Phone:704-366-8712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-15
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500785821041C0700X
MD149201041C0700X
NCC0085561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical