Gary Lee Coleman, PSY. D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Practice address

2114 Deerpath Rd
Aurora, IL 60506-7943

Phone

(630) 907-1735

Fax

(630) 907-1738

NPI assigned

Feb 4, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Waterford Counseling and Psychological Services PCGroup PAC ID 7012144017, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Waterford Counseling and Psychological Services, PC

  • Clinical Psychologist
  • Aurora, IL
  • NPI 1104250067
  Medicare reassignment Care Compare group NPD Authorized official
• Gary Coleman, Psy.D. & Associates

  • Clinical Psychologist
  • Aurora, IL
  • NPI 1114181971
  NPD (past) Authorized official

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

{
    "created_epoch": "1170547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407994049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 DEERPATH RD",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605067943",
            "telephone_number": "630-907-1735",
            "fax_number": "630-907-1738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2114 DEERPATH RD",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605067943",
            "telephone_number": "630-907-1735",
            "fax_number": "630-907-1738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "GARY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PSY. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Lee Cole, LCSW, LISW
• Laura A Cole, M.S., CCC-SLP
• Michael James Cole
• Tracey Cole
• Amy L Coleman, LCSW
• Shatrece Coleman
• Tracie Marie Coleman, LCSW
• Joseph Colletti
• Autumn Collins
• David Collins Jr.

• Clinical Psychologist in Aurora, IL
• Providers in Aurora, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.