Active NPI
Irene Coleman, MA
- Marriage & Family Therapist
- Lafayette, CA
National Provider Identifier
1619029345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMF 49359
- Practice address
- 3468 Mt Diablo Blvd
Lafayette, CA 94549-3957 - Phone
- (925) 876-9498
- Fax
- (925) 254-1599
- NPI assigned
- Jan 16, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF 49359 | CA | Primary |
Addresses
Primary practice location
3468 Mt Diablo Blvd
Lafayette, CA 94549-3957
Mailing address
3468 Mt Diablo Blvd
Lafayette, CA 94549-3957
Phone (925) 876-9498
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF 49359 | CA | MD | Marriage & Family Therapist |
| 45191 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619029345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3468 MT DIABLO BLVD",
"city": "LAFAYETTE",
"state": "CA",
"postal_code": "945493957",
"telephone_number": "925-876-9498",
"fax_number": "925-254-1599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3468 MT DIABLO BLVD",
"city": "LAFAYETTE",
"state": "CA",
"postal_code": "945493957",
"telephone_number": "925-876-9498",
"fax_number": "925-254-1599"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLEMAN",
"first_name": "IRENE",
"name_prefix": "Ms.",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF 49359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, CA
Sources for this page
- 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.