Active NPI
Monique N. Coleman, PSY.D.
- Clinical Psychologist
- Peachtree City, GA
National Provider Identifier
1154654366
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY003313
- Practice address
- 23 Eastbrook BND Ste 200
Peachtree City, GA 30269-1554 - Phone
- (770) 865-8535
- NPI assigned
- Sep 8, 2009
- 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 |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | PSY003313 | GA | |
| Clinical Psychologist | 103TC0700X | PSY003313 | GA | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | PSY003313 | GA | |
| Family Psychologist | 103TF0000X | PSY003313 | GA | |
| Forensic Psychologist | 103TF0200X | PSY003313 | GA | |
| Group Psychotherapy Psychologist | 103TP2701X | PSY003313 | GA |
Addresses
Primary practice location
23 Eastbrook BND Ste 200
Peachtree City, GA 30269-1554
Mailing address
PO Box 101
Fayetteville, GA 30214-0101
Phone (770) 865-8535
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 |
|---|---|---|---|
| PSY003313 | GA | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351728000000",
"number": "1154654366",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 101",
"city": "FAYETTEVILLE",
"state": "GA",
"postal_code": "302140101",
"telephone_number": "770-865-8535"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 EASTBROOK BND STE 200",
"city": "PEACHTREE CITY",
"state": "GA",
"postal_code": "302691554",
"telephone_number": "770-865-8535"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "MONIQUE",
"middle_name": "N.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-09-08",
"last_updated": "2012-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "GA",
"license": "PSY003313",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "PSY003313",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "GA",
"license": "PSY003313",
"primary": false
},
{
"code": "103TF0000X",
"taxonomy_group": "",
"desc": "Psychologist, Family",
"state": "GA",
"license": "PSY003313",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "GA",
"license": "PSY003313",
"primary": false
},
{
"code": "103TP2701X",
"taxonomy_group": "",
"desc": "Psychologist, Group Psychotherapy",
"state": "GA",
"license": "PSY003313",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peachtree City, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.