Provider Demographics
NPI:1851144653
Name:COLEMAN, N'DEA
Entity Type:Individual
Prefix:
First Name:N'DEA
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 SWINSON DRIVE, DUDLEY, NC, USA
Mailing Address - Street 2:
Mailing Address - City:DUDLEY
Mailing Address - State:NC
Mailing Address - Zip Code:28333
Mailing Address - Country:US
Mailing Address - Phone:734-347-6301
Mailing Address - Fax:
Practice Address - Street 1:1915 CHAPEL HILL RD STE A
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27707-1177
Practice Address - Country:US
Practice Address - Phone:919-246-5664
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19459101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health