Provider Demographics
NPI:1427724384
Name:COLEMAN, ELIZABETH EVA (LMSW)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:EVA
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 ASHLAND AVE UPPR
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14222-1764
Mailing Address - Country:US
Mailing Address - Phone:206-512-6570
Mailing Address - Fax:
Practice Address - Street 1:333 ASHLAND AVE UPPR
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14222-1764
Practice Address - Country:US
Practice Address - Phone:206-512-6570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-20
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113655-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health