Provider Demographics
NPI:1962689679
Name:COLEMAN, ELIZABETH L (LICSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:L
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 PENNSYLVANIA AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-2167
Mailing Address - Country:US
Mailing Address - Phone:202-381-3982
Mailing Address - Fax:202-683-1155
Practice Address - Street 1:1012 14TH ST NW STE 1000
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-3452
Practice Address - Country:US
Practice Address - Phone:202-654-5101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD147701041C0700X
DCLC500787251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD233823800Medicaid