Provider Demographics
NPI:1912144262
Name:COLEMAN-ZAMORA, FALANA CHARICE (LCSW)
Entity Type:Individual
Prefix:
First Name:FALANA
Middle Name:CHARICE
Last Name:COLEMAN-ZAMORA
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 1:5200 S ELLIS AV
Mailing Address - Street 2:104
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-4367
Mailing Address - Country:US
Mailing Address - Phone:312-388-0620
Mailing Address - Fax:
Practice Address - Street 1:1 E SUPERIOR ST
Practice Address - Street 2:410
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2507
Practice Address - Country:US
Practice Address - Phone:312-388-0620
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0120721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical