Coleman, Jordan A
Coleman, Jordan A is an sole proprietor health care provider with primary practice located at 1675 E Seminole St Ste A1 , Springfield MO 65804-2454. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Coleman, Jordan A can be contacted via phone (417) 597-4309.Contact Information
Primary practice address
1675 E Seminole St Ste A1
Springfield MO 65804-2454
Phone: (417) 597-4309
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2016034046 | Missouri |
Profile Details
| NPI number | 1275081333 |
|---|---|
| LBN Legal business name | Coleman, Jordan A |
| Credentials | PSYD, LP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 19th, 2016 |
| Last updated | Apr 26th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1275081333 | NPPES |
| Missouri | MEDICAID | 490035887 |
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