Jennifer Coleman, PHD
Individual provider Active NPI Clinical Psychologist · Quantico, VA
NPI 1841686565 · NPPES record last updated May 11, 2023
Key facts
- NPI
- 1841686565
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 612 (WY)
- Practice address
- Suite W-1683
27130 Telegraph Rd.
Quantico, VA 22134 - Phone
- (501) 987-7338
- NPI assigned
- Apr 9, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 612 | WY | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 612 | WY | Yes |
Addresses
Primary practice location
Suite W-1683
27130 Telegraph Rd.
Quantico, VA 22134
Mailing address
Suite W-1683
27130 Telegraph Rd.
Quantico, VA 22134
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 612 | Other | WY | BOARD OF PSYCHOLOGY |
Other providers in Quantico, VA
- Megan Challacombe
- In Hyok Choi
- Rafael G Cohen
- Vicki Jo Colapietro
- Ashton Colbert
- Elizabeth Coenen Cooper
- Alyssa Cox
- Credible Nurses
- Joshua V Crisano
- Jessica L Crompton
All providers in Quantico, VA · Clinical Psychologist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.