Provider Demographics
NPI:1912960683
Name:COLEMAN, THOMAS EARL (PHD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:EARL
Last Name:COLEMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:608 BURKE TRL
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-2902
Mailing Address - Country:US
Mailing Address - Phone:336-472-3500
Mailing Address - Fax:
Practice Address - Street 1:608 BURKE TRL
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-2902
Practice Address - Country:US
Practice Address - Phone:336-472-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2008-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC101101YA0400X
NC635101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC010699945OtherHEALTHCARE SAVINGS -MGD.
NC149114OtherVALUEOPTIONS - MGD. CARE
NC180615OtherMANAGED HEALTH NETWORK
NC21190751354OtherBEECH STREET - INS.
NC294671OtherMAGELLAN BEH. HEA. -MGD.
NC5267686OtherFIRSTHEALTH - INSURANCE
NC294671OtherAETNA U.S. HEALTHCARE INS
NC719313OtherCCN - INS.
NC95160OtherMEDCOST - 3RD PARTY ADM.
NC1053159OtherCIGNA BEH. HEA.-MGD. CARE
NC7342103OtherAETNA INC. - INSURANCE
NC6102026Medicaid
NC010699945OtherHORIZON BEH SERVICES -MGD
NC32158-01OtherCAROLINA BEH. HEA. ALLIAN
NC010699945OtherUNITED BEHAVIORAL HEALTH
NC188957OtherCOMPSYCH - MGD. CARE
NC23625OtherBLUE CROSS BLUE SHIELD