Individual
MRS. LISA COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CDW
Contact information
Practice address
411 E CHESTNUT ST # 6, LOUISVILLE, KY 40202-1713
(502) 588-3650
(502) 588-7852
Mailing address
PO BOX 776879, CHICAGO, IL 60677-6879
(502) 588-9490
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
KY6961
KY
1041C0700X
Clinical Social Worker
Primary
255270
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
29102357
—
KY
Enumeration date
05/08/2014
Last updated
02/07/2025
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