Healthcare Provider Details

I. General information

NPI: 1518552868
Provider Name (Legal Business Name): THE COPING CORNER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2021
Last Update Date: 01/17/2022
Certification Date: 01/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1151 WALKER RD PMB# 134
DOVER DE
19904
US

IV. Provider business mailing address

1151 WALKER RD PMB# 134
DOVER DE
19904
US

V. Phone/Fax

Practice location:
  • Phone: 240-712-4199
  • Fax: 240-235-7117
Mailing address:
  • Phone: 240-712-4199
  • Fax: 240-235-7117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MACIE QUARLES
Title or Position: THERAPIST
Credential: LCSWC
Phone: 240-712-4199