Provider Demographics
NPI:1780058198
Name:COLEMAN, DREANA MOET (LMSW)
Entity type:Individual
Prefix:MRS
First Name:DREANA
Middle Name:MOET
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4383 MURDOCK AVE # 3
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-1821
Mailing Address - Country:US
Mailing Address - Phone:914-469-3485
Mailing Address - Fax:
Practice Address - Street 1:4383 MURDOCK AVE # 3
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-1821
Practice Address - Country:US
Practice Address - Phone:914-469-3485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY084758-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health