Healthcare Provider Details

I. General information

NPI: 1508255100
Provider Name (Legal Business Name): DENISE COYNE LCHMC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2015
Last Update Date: 06/27/2023
Certification Date: 06/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 AVIATION PKWY STE 400
MORRISVILLE NC
27560-6603
US

IV. Provider business mailing address

4702 FRIARS LN
GREENSBORO NC
27455-1537
US

V. Phone/Fax

Practice location:
  • Phone: 888-510-1352
  • Fax:
Mailing address:
  • Phone: 734-771-5228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number18327
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701010918
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2015026275
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: