Healthcare Provider Details

I. General information

NPI: 1407658115
Provider Name (Legal Business Name): JEANNIE COFFMAN MSW, LCSW-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/25/2025
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1829 E FRANKLIN ST STE 800D
CHAPEL HILL NC
27514-5868
US

IV. Provider business mailing address

1829 E FRANKLIN ST STE 800D
CHAPEL HILL NC
27514-5868
US

V. Phone/Fax

Practice location:
  • Phone: 919-704-8449
  • Fax: 919-704-8617
Mailing address:
  • Phone: 919-704-8449
  • Fax: 919-704-8617

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP023734
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: