Provider Demographics
NPI:1114898574
Name:COLEMAN, KELCY R (MA BCBA LBA)
Entity type:Individual
Prefix:MS
First Name:KELCY
Middle Name:R
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:MA BCBA LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 SMITH ST APT 311
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-8731
Mailing Address - Country:US
Mailing Address - Phone:715-641-1543
Mailing Address - Fax:
Practice Address - Street 1:2453 S BRAESWOOD BLVD STE 201
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4305
Practice Address - Country:US
Practice Address - Phone:715-641-1543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8951103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst