Provider Demographics
NPI:1922576511
Name:JODI COOLMAN, LLC
Entity Type:Organization
Organization Name:JODI COOLMAN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JODI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:COOLMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:906-228-8744
Mailing Address - Street 1:1815 WILKINSON AVE
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-2128
Mailing Address - Country:US
Mailing Address - Phone:906-228-8744
Mailing Address - Fax:
Practice Address - Street 1:706 CHIPPEWA SQ STE 208
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-4813
Practice Address - Country:US
Practice Address - Phone:906-228-8744
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-13
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty