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Organization

COLEMAN PROFESSIONAL SERVICES, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. DIANA KEATHLEY (CREDENTIALING SPECIALIST)
(330) 676-6826
Entity
Organization

Contact information

Practice address
5982 RHODES RD, KENT, OH 44240-4128
(330) 673-1347
(330) 678-3677
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
Primary
0227
OH
101YP2500X
Professional Counselor
0227
OH
103T00000X
Psychologist
0227
OH
103TB0200X
Cognitive & Behavioral Psychologist
0227
OH
103TC0700X
Clinical Psychologist
0227
OH
103TC1900X
Counseling Psychologist
0227
OH
103TC2200X
Clinical Child & Adolescent Psychologist
0227
OH
104100000X
Social Worker
0227
OH
1041C0700X
Clinical Social Worker
0227
OH
2084P0800X
Psychiatry Physician
0227
OH
2084P0804X
Child & Adolescent Psychiatry Physician
0227
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8215
PORTAGE COUNTY MACSIS UPI
OH
Enumeration date
07/08/2006
Last updated
11/01/2007
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