Provider Demographics
NPI:1750560157
Name:COULTER, MICHAEL FRANCIS (LMSW, MACSS)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:FRANCIS
Last Name:COULTER
Suffix:
Gender:M
Credentials:LMSW, MACSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 S CROCKETT ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75090-8513
Mailing Address - Country:US
Mailing Address - Phone:903-813-4889
Mailing Address - Fax:
Practice Address - Street 1:4500 SOUTH LANCASTER RD.
Practice Address - Street 2:BUILDING 69
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-7191
Practice Address - Country:US
Practice Address - Phone:214-857-1254
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX298981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical