Active NPI
Brent Robert Coleman, M.A.
- Professional Counselor
- San Rafael, CA
National Provider Identifier
1144436718
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2355
- Practice address
- 130 Altena St
San Rafael, CA 94901-5200 - Phone
- (720) 341-8985
- NPI assigned
- May 14, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2355 | CA | Primary |
Addresses
Primary practice location
130 Altena St
San Rafael, CA 94901-5200
Mailing address
130 Altena St
San Rafael, CA 94901-5200
Phone (720) 341-8985
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2355 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549929600000",
"number": "1144436718",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 ALTENA ST",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949015200",
"telephone_number": "720-341-8985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 ALTENA ST",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949015200",
"telephone_number": "720-341-8985"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "BRENT",
"middle_name": "ROBERT",
"name_prefix": "Mr.",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-14",
"last_updated": "2019-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "2355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.