| Full Name | Keisha Coleman |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 102 Bond St, Berea, Kentucky |
| Authorized Official Name and Position | Heather Wilson (CREDENTIALING MANAGER) |
| Authorized Official Contact | 9038188312 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Keisha Coleman 102 Bond St Berea KY 40403-1502 Ph: () - | Keisha Coleman 102 Bond St Berea KY 40403-1502 Ph: (859) 353-7562 |
| NPI Number | 1992440259 |
|---|---|
| Provider Enumeration Date | 05/02/2022 |
| Last Update Date | 03/11/2023 |
| Certification Date | 03/11/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992440259 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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