Provider Demographics
NPI:1982819090
Name:COLEMAN, KATHERINE E (MS , LPC)
Entity Type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:E
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MS , LPC
Other - Prefix:MS
Other - First Name:KAY
Other - Middle Name:
Other - Last Name:COLEMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:PO BOX 780366
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78278-0366
Mailing Address - Country:US
Mailing Address - Phone:210-366-6777
Mailing Address - Fax:
Practice Address - Street 1:7522 STEEPLE DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78256-1654
Practice Address - Country:US
Practice Address - Phone:210-366-6777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9920101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX9920OtherSTATE LICENSE NUMBER
TX1652LCOtherBCBS PROVIDER NUMBER