Provider Demographics
NPI:1386350940
Name:SALISBURY, COLEMAN
Entity type:Individual
Prefix:
First Name:COLEMAN
Middle Name:
Last Name:SALISBURY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 EVANS ST STE 104
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45204-2075
Mailing Address - Country:US
Mailing Address - Phone:513-903-6559
Mailing Address - Fax:
Practice Address - Street 1:801 EVANS ST STE 104
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45204-2075
Practice Address - Country:US
Practice Address - Phone:513-903-6559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-26
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)