Provider Demographics
NPI:1750684452
Name:COLEMAN, KARA BECKETT (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KARA
Middle Name:BECKETT
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:563 IVEY WAY SE
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-4563
Mailing Address - Country:US
Mailing Address - Phone:678-438-9084
Mailing Address - Fax:
Practice Address - Street 1:563 IVEY WAY SE
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-4563
Practice Address - Country:US
Practice Address - Phone:678-438-9084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-19
Last Update Date:2010-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0043771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical