Provider Demographics
NPI:1427243625
Name:COLEMAN, JENNIFER CLAIRE (LMHC)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CLAIRE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:452 RIVER DR
Mailing Address - Street 2:
Mailing Address - City:HADLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01035-9669
Mailing Address - Country:US
Mailing Address - Phone:413-824-9186
Mailing Address - Fax:
Practice Address - Street 1:452 RIVER DR
Practice Address - Street 2:
Practice Address - City:HADLEY
Practice Address - State:MA
Practice Address - Zip Code:01035-9669
Practice Address - Country:US
Practice Address - Phone:413-824-9186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1571101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health