Individual
MS. GINA ROSE COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, CRC, CADC
Contact information
Practice address
510 N VIRGINIA AVE, GLENWOOD, IL 60425-1021
(708) 212-0056
Mailing address
510 N VIRGINIA AVE, GLENWOOD, IL 60425-1021
(708) 212-0056
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
180014627
IL
101YP2500X
Professional Counselor
178.015298
IL
225C00000X
Rehabilitation Counselor
Primary
373285
IL
Other
Enumeration date
04/27/2022
Last updated
02/23/2023
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