Michael Coleman, CADCII CCJP

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

251500000X Issued in CA

Practice address

171 Carlos Dr
San Rafael, CA 94903-2005

Phone

(415) 444-5580

NPI assigned

Jan 21, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1421798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1194114652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 CARLOS DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032005",
            "telephone_number": "415-444-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 CARLOS DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032005",
            "telephone_number": "415-444-5580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "MICHAEL",
        "credential": "CADCII CCJP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-01-21",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "251500000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY BEHAVIOR HEALTH",
            "identifier": "94 2346815",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Uri Elie Cohen, M.D.
• Ian Chapin Coit
• Henry Colbert
• Brent Robert Coleman, M.A.
• Cayla Werner Coleman, LCSW
• Barbara Coley, MHRS
• Harry Collamore, MFT
• India V Collins, PSY.D.
• Jerycka N Collins, RBT
• Joan Barbara Collins, DPT

• Addiction (Substance Use Disorder) Counselor in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2015; 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.