Lavern L Coleman

Individual provider Active NPI Mental Health Counselor · Rolling Fork, MS

NPI 1104789239 · NPPES record last updated Dec 5, 2025

Key facts

NPI
1104789239
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
CMHT (MS)
Practice address
317 W Race St
Rolling Fork, MS 39159-2623
Phone
(662) 873-6228
Fax
(662) 873-2244
NPI assigned
Dec 5, 2025
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CMHTMSMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Community Mental Health Services Past
since Dec 7, 2025
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CMHT MS Yes

Addresses

Primary practice location

317 W Race St
Rolling Fork, MS 39159-2623

Mailing address

2504 Browning Road 520
Greenwood, MS 38930-6022
Phone (662) 451-6211

Other providers in Rolling Fork, MS

All providers in Rolling Fork, MS · Mental Health Counselor in Mississippi

Sources for this page

Verify at the official NPI Registry.