Provider Demographics
NPI:1023657079
Name:COLEMAN, CHAKA-MONIQUE (PHD)
Entity type:Individual
Prefix:DR
First Name:CHAKA-MONIQUE
Middle Name:
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 COMMACK DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-6771
Mailing Address - Country:US
Mailing Address - Phone:832-404-3635
Mailing Address - Fax:
Practice Address - Street 1:150 PROVIDENCE RD STE 101
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-2208
Practice Address - Country:US
Practice Address - Phone:919-446-3334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-21
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5677103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical