Provider Demographics
NPI:1215319421
Name:COLEMAN, ALECE CHANEL (LCSW)
Entity type:Individual
Prefix:
First Name:ALECE
Middle Name:CHANEL
Last Name:COLEMAN
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 1:60 ROOSEVELT AVE APT 3207
Mailing Address - Street 2:
Mailing Address - City:CARTERET
Mailing Address - State:NJ
Mailing Address - Zip Code:07008-2487
Mailing Address - Country:US
Mailing Address - Phone:917-288-4776
Mailing Address - Fax:
Practice Address - Street 1:60 ROOSEVELT AVE APT 3207
Practice Address - Street 2:
Practice Address - City:CARTERET
Practice Address - State:NJ
Practice Address - Zip Code:07008-2487
Practice Address - Country:US
Practice Address - Phone:917-288-4776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-24
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056053001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical