Provider Demographics
NPI:1912473489
Name:COOLMAN, JODI MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:MARIE
Last Name:COOLMAN
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 1:706 CHIPPEWA SQ STE 208
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-4813
Mailing Address - Country:US
Mailing Address - Phone:906-228-8744
Mailing Address - Fax:
Practice Address - Street 1:706 CHIPPEWA SQ STE 208
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855-4813
Practice Address - Country:US
Practice Address - Phone:906-228-8744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-22
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011178981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical