Charles T Coleman, MA

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Newton, IL

NPI 1508093535 · NPPES record last updated Sep 6, 2012

Key facts

NPI
1508093535
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
106 Edwards St
Newton, IL 62448-1736
Phone
(618) 783-4154
Fax
(217) 783-2339
NPI assigned
Jun 17, 2009
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

106 Edwards St
Newton, IL 62448-1736

Mailing address

106 Edwards St
Newton, IL 62448-1736
Phone (618) 783-4154

Other providers in Newton, IL

All providers in Newton, IL · Addiction (Substance Use Disorder) Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.