Jennifer Maria Coleman, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

2012036891 Issued in MO

Practice address

785 Wall St
O Fallon, IL 62269-1959

Phone

(618) 212-3124

NPI assigned

Sep 26, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Transformative Beginnings, LLC

  • Clinical Social Worker
  • O'Fallon, IL
  • NPI 1497311716
  NPD (past) Authorized official

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

{
    "created_epoch": "1380153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1417383134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1452 SCHWARZ MEADOW DR",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622696709",
            "telephone_number": "618-212-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 WALL ST",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691959",
            "telephone_number": "618-212-3124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "JENNIFER",
        "middle_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-26",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149021202",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MO",
            "license": "2012036891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tina Ann Cloin, PA-C
• Teresa Cockrell
• Brandie Elise Colebrooke
• Cyara Lanette Coleman, ED.S, MA, BCBA, LBA
• Evelyn Coleman
• Darcie Collico, PT
• Camryn Kristin Collins-Vaughn
• Demingo Collins
• Colonnade Senior Development, LLC (Colonnade Senior Living)
• Martin J Conaughty, HIS

• Social Worker in O'Fallon, IL
• Providers in O'Fallon, IL by specialty
• Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.