Provider Demographics
NPI:1780933556
Name:COLEMAN, CHALONDA MICHELLE (LCSW)
Entity type:Individual
Prefix:
First Name:CHALONDA
Middle Name:MICHELLE
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 1:60 COMMERCE PLAZA CIR
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NC
Mailing Address - Zip Code:28372-7386
Mailing Address - Country:US
Mailing Address - Phone:910-521-2900
Mailing Address - Fax:910-775-9165
Practice Address - Street 1:3750 MEADOW VIEW RD
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-1920
Practice Address - Country:US
Practice Address - Phone:910-618-9912
Practice Address - Fax:910-618-0728
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-07
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0062721041C0700X
NCC0082301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical