Provider Demographics
NPI:1710555354
Name:COLEMAN-BROWN, SHAURI (LMHC)
Entity type:Individual
Prefix:
First Name:SHAURI
Middle Name:
Last Name:COLEMAN-BROWN
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6424 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-2091
Mailing Address - Country:US
Mailing Address - Phone:253-565-4484
Mailing Address - Fax:
Practice Address - Street 1:621 PACIFIC AVE STE 212
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-4619
Practice Address - Country:US
Practice Address - Phone:253-457-9821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-10
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61149147101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA61149147OtherDOH