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Organization

COLEMAN PROFESSIONAL SERVICES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DIANA D. KEATHLEY (CREDENTIALING SPECIALIST)
(330) 676-6875
Entity
Organization

Contact information

Practice address
400 TUSCARAWAS ST W, SUITE 200, CANTON, OH 44702-2018
(330) 438-2400
(330) 438-3003
Mailing address
5982 RHODES RD, KENT, OH 44240-4128
(330) 673-1347
(330) 678-3677

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
0277
OH
103TC0700X
Clinical Psychologist
0277
OH
103TC1900X
Counseling Psychologist
0277
OH
104100000X
Social Worker
0227
OH
1041C0700X
Clinical Social Worker
0277
OH
2084P0800X
Psychiatry Physician
0277
OH
251S00000X
Community/Behavioral Health Agency
Primary
0227
OH

Other

Enumeration date
11/30/2006
Last updated
01/05/2017
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