Provider Demographics
NPI:1114404423
Name:COLEMAN, JOSEPH PATRICK (PHD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:PATRICK
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 1:306 WASHINGTON ST # 202
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-5162
Mailing Address - Country:US
Mailing Address - Phone:917-283-2284
Mailing Address - Fax:
Practice Address - Street 1:306 WASHINGTON ST # 202
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-5162
Practice Address - Country:US
Practice Address - Phone:917-283-2284
Practice Address - Fax:248-451-9089
Is Sole Proprietor?:No
Enumeration Date:2018-07-20
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301017173103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical