Provider Demographics
NPI:1922141662
Name:COLEMAN, STEFANIE HILDA (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:STEFANIE
Middle Name:HILDA
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 TENTMILL LN APT I
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-2529
Mailing Address - Country:US
Mailing Address - Phone:410-744-7076
Mailing Address - Fax:410-744-9563
Practice Address - Street 1:6630 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:205B
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-3920
Practice Address - Country:US
Practice Address - Phone:410-744-7076
Practice Address - Fax:410-744-9563
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD097321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical