Deja Monet Coleman

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

3007 Harbor LN N
Plymouth, MN 55447-5103

Phone

(612) 445-8314

NPI assigned

Aug 9, 2021

Sex

Female

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1245904648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5908 2 1/2 ST NE APT 4",
            "city": "FRIDLEY",
            "state": "MN",
            "postal_code": "554325588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 HARBOR LN N",
            "city": "PLYMOUTH",
            "state": "MN",
            "postal_code": "554475103",
            "telephone_number": "612-445-8314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "DEJA",
        "middle_name": "MONET",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-09",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBA",
            "identifier": "103K0000X",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Caravelautism.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "address_1": "3007 Harbor Ln N",
            "city": "Plymouth",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554475103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Keighly Colangelo, RDN, LD
• Tammy Anne Colbeth, CMT, LMT
• Cole Vision Corporation
• Jasmine Kiara Norella Cole
• Olivia Cole
• Peter William Coleman
• Grace Moore Colestock
• Gretchen Carlson Collins, MA, LP
• Kelsey Collins
• Comforide Transportation Services LLC

• Behavior Analyst in Plymouth, MN
• Providers in Plymouth, MN by specialty
• Behavior Analyst in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2021; 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.