Dr. Coleman Psychology

Primary specialty

PsychologistTaxonomy code 103T00000X

Legal business name

DR. COLEMAN PSYCHOLOGY

Practice address

100 E Pitt St Ste 202
Bedford, PA 15522-1358

Phone

(814) 977-4417

Fax

(814) 310-2662

NPI assigned

Jul 22, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Rebecca Coleman, PSY.D

Title

Sole Proprietor

Phone

(772) 766-4441

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565049600000",
    "number": "1215192018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S RICHARD ST",
            "city": "BEDFORD",
            "state": "PA",
            "postal_code": "155221840",
            "telephone_number": "814-977-4417",
            "fax_number": "814-310-2662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E PITT ST STE 202",
            "city": "BEDFORD",
            "state": "PA",
            "postal_code": "155221358",
            "telephone_number": "814-977-4417",
            "fax_number": "814-310-2662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3055 Cardinal Dr",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Vero Beach",
            "state": "FL",
            "postal_code": "329634920",
            "country_code": "US",
            "telephone_number": "772-231-2333",
            "fax_number": "772-231-1398",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DR. COLEMAN PSYCHOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2019-08-06",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "772-766-4441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA LICENSE",
            "identifier": "PS017150",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.

Verify at the official NPI Registry.