Provider Demographics
NPI:1992513261
Name:COLMAN, GABRIEL JOSEF (MSW)
Entity type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:JOSEF
Last Name:COLMAN
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 S OLCOTT BLVD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-7127
Mailing Address - Country:US
Mailing Address - Phone:463-303-9125
Mailing Address - Fax:
Practice Address - Street 1:304 W HOWE ST STE B
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-2347
Practice Address - Country:US
Practice Address - Phone:812-369-4390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty