Individual provider Active NPI

Michelle S. Coleman, LPC

  • Professional Counselor
  • Little Rock, AR
National Provider Identifier
1588651483
Registry record updated Jan 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
P0501002 Issued in AR
Practice address
4 Shackleford PLZ Ste 202a
Little Rock, AR 72211-1844
Phone
(501) 588-7800
NPI assigned
Oct 5, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 11619 CA
Professional Counselor 101YP2500X 37PC00883200 NJ
Professional Counselor 101YP2500X P0501002 AR Primary

Addresses

Primary practice location

4 Shackleford PLZ Ste 202a
Little Rock, AR 72211-1844

Mailing address

11415 Huron LN Unit 22205
Little Rock, AR 72221-7125
Phone (501) 588-7800

Other identifiers 1

IdentifierTypeStateIssuer
5Y519OtherARBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20250522001872 AR Practitioner - Mental Health Counselor 5698294692

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
P0501002ARMDProfessional Counselor
37PC00883200NJMDProfessional Counselor
11619CAMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Professional Current Accepting new patients
The Family Institute of Arkansas Professional CurrentSince Nov 1, 2021 Accepting new patients

Locations

15300 Kanis Rd
Ste 103
Little Rock, AR 72223

Interoperability endpoints

  • Direct secure messaging: michellecoleman@tdh.allscriptsdirect.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673395200000",
    "number": "1588651483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11415 HURON LN UNIT 22205",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722217125",
            "telephone_number": "501-588-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 SHACKLEFORD PLZ STE 202A",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722111844",
            "telephone_number": "501-588-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "MICHELLE",
        "middle_name": "S.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-05",
        "last_updated": "2023-01-11",
        "certification_date": "2023-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "11619",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00883200",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AR",
            "license": "P0501002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "5Y519",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.