Active NPI
Habeebah Rene Coleman
- Clinical Social Worker
- Los Angeles, CA
National Provider Identifier
1053782029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 110986
- Practice address
- 840 N Avenue 66
Los Angeles, CA 90042-1508 - Phone
- (424) 703-5773
- NPI assigned
- Oct 15, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 6
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | |||
| Psychologist | 103T00000X | |||
| Clinical Social Worker | 1041C0700X | |||
| Counselor | 101Y00000X | |||
| Clinical Social Worker | 1041C0700X | 110986 | CA | Primary |
| Mental Health Counselor | 101YM0800X | ACSW74583 | CA |
Addresses
Primary practice location
840 N Avenue 66
Los Angeles, CA 90042-1508
Mailing address
145 N 5TH St Unit 694
Montebello, CA 90640-6842
Phone (424) 703-5773
Other practice location 1
40015 Sierra Hwy Ste B280
Palmdale, CA 93550-2143
Phone (424) 777-3404
Other practice location 2
3850 Crenshaw Blvd
Los Angeles, CA 90008-1821
Phone (323) 751-3026
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ACSW74583 | CA | MD | Mental Health Counselor |
| 110986 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern California Health & Rehabilitation Program | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Lynwood, CA
- NPI 1467775221
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1444867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781308800000",
"number": "1053782029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 N 5TH ST UNIT 694",
"city": "MONTEBELLO",
"state": "CA",
"postal_code": "906406842",
"telephone_number": "424-703-5773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "840 N AVENUE 66",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900421508",
"telephone_number": "424-703-5773"
}
],
"practiceLocations": [
{
"address_1": "40015 Sierra Hwy Ste B280",
"address_purpose": "LOCATION",
"city": "Palmdale",
"state": "CA",
"postal_code": "935502143",
"country_code": "US",
"telephone_number": "424-777-3404",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3850 Crenshaw Blvd",
"address_purpose": "LOCATION",
"city": "Los Angeles",
"state": "CA",
"postal_code": "900081821",
"country_code": "US",
"telephone_number": "323-751-3026",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "COLEMAN",
"first_name": "HABEEBAH RENE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-10-15",
"last_updated": "2026-06-13",
"certification_date": "2026-06-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "110986",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "ACSW74583",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.