Healthcare Provider Details
I. General information
NPI: 1336556901
Provider Name (Legal Business Name): AMY WEEKS-COFFIELD LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/16/2014
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6 OLD ROCHESTER RD STE 106
DOVER NH
03820-2028
US
IV. Provider business mailing address
6 OLD ROCHESTER ROAD SUITE 106
DOVER NH
03820
US
V. Phone/Fax
- Phone: 603-770-9937
- Fax: 603-743-3244
- Phone: 603-770-9937
- Fax: 603-743-3244
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | 1946 |
| License Number State | NH |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1041C0700X |
| Taxonomy | Clinical Social Worker |
| License Number | |
| License Number State | NH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: