Provider Demographics
NPI:1023444627
Name:COLEMAN, BROOKE K (LCSW)
Entity type:Individual
Prefix:
First Name:BROOKE
Middle Name:K
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 CLARMONT AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-5705
Mailing Address - Country:US
Mailing Address - Phone:267-525-7001
Mailing Address - Fax:
Practice Address - Street 1:800 CLARMONT AVE
Practice Address - Street 2:SUITE B
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-5705
Practice Address - Country:US
Practice Address - Phone:267-525-7001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-16
Last Update Date:2013-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0148581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical