Individual provider Active NPI

Susanne Terri Coleman, PH.D., L.M.F.T.,

  • Marriage & Family Therapist
  • Oakland Park, FL
National Provider Identifier
1073059788
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT1725 Issued in FL
Practice address
3455 NE 12TH Ter Ste 9
Oakland Park, FL 33334-4534
Phone
(954) 644-9331
NPI assigned
Jan 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT1725 FL Primary

Addresses

Primary practice location

3455 NE 12TH Ter Ste 9
Oakland Park, FL 33334-4534

Mailing address

2725 NE 25TH St
Ft Lauderdale, FL 33305-1701
Phone (954) 644-9331

Other practice location 1

2725 NE 25th St
Ft Lauderdale, FL 33305-1701
Phone (954) 644-9331

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MT1725FLMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1073059788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 NE 25TH ST",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333051701",
            "telephone_number": "954-644-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 NE 12TH TER STE 9",
            "city": "OAKLAND PARK",
            "state": "FL",
            "postal_code": "333344534",
            "telephone_number": "954-644-9331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2725 NE 25th St",
            "address_purpose": "LOCATION",
            "city": "Ft Lauderdale",
            "state": "FL",
            "postal_code": "333051701",
            "country_code": "US",
            "telephone_number": "954-644-9331",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "SUSANNE",
        "middle_name": "TERRI",
        "name_prefix": "Dr.",
        "credential": "PH.D., L.M.F.T.,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-19",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT1725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.