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NPI Code Detail

MEDICARE: CRISTA ELIZABETH COFFING-BLAIN LMHC

MEDICARE: CRISTA ELIZABETH COFFING-BLAIN LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorATR00-141FL
2101YM0800XMental Health CounselorIMH11428FL
3221700000XArt Therapist00-141NM
4221700000XArt Therapist00-141FL
5101YM0800XMental Health Counselor16915FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053723411
Entity Type Code : Individual
Provider Name (Legal Business Name) : CRISTA ELIZABETH COFFING-BLAIN LMHC
Provider Business Mailing Address
First Line : 255 S ORANGE AVE SUITE 104 #1446
Second Line :
City : ORLANDO
State : FL
Zip : 32801
Country : US
Telephone Number : 904-720-7629
Fax Number :
Provider Business Practice Location Address
First Line : 255 S ORANGE AVE SUITE 104 #1446
Second Line :
City : ORLANDO
State : FL
Zip : 32801
Country : US
Telephone Number : 904-720-7629
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2014
Last Update Date : 09/20/2024

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Directions to “ CRISTA ELIZABETH COFFING-BLAIN LMHC” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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