Provider Demographics
NPI:1821246463
Name:LEMMONS, COLEMAN L JR (LPC, LADC)
Entity Type:Individual
Prefix:
First Name:COLEMAN
Middle Name:L
Last Name:LEMMONS
Suffix:JR
Gender:M
Credentials:LPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 NW 167TH ST
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-6809
Mailing Address - Country:US
Mailing Address - Phone:405-406-3104
Mailing Address - Fax:
Practice Address - Street 1:1009 NW 167TH ST
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-6809
Practice Address - Country:US
Practice Address - Phone:405-406-3104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2008-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
OK140101YA0400X
OK3560101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health