Individual provider Active NPI

Stephanie Patryce Coleman

  • Marriage & Family Therapist
  • Corte Madera, CA
National Provider Identifier
1114556834
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
49518 Issued in CA
Practice address
6 Fairview Ave
Corte Madera, CA 94925-1604
Phone
(415) 820-1512
NPI assigned
Apr 4, 2020
Last updated
Jun 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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 49518 CA Primary

Addresses

Primary practice location

6 Fairview Ave
Corte Madera, CA 94925-1604

Mailing address

1679 Jackman St
Port Townsend, WA 98368-6027
Phone (415) 820-1512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
46518CAMDMarriage & Family Therapist
49518CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1585958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1114556834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1679 JACKMAN ST",
            "city": "PORT TOWNSEND",
            "state": "WA",
            "postal_code": "983686027",
            "telephone_number": "415-820-1512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 FAIRVIEW AVE",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251604",
            "telephone_number": "415-820-1512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "STEPHANIE",
        "middle_name": "PATRYCE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-04",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "49518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corte Madera, CA

Sources for this page

Verify at the official NPI Registry.