Healthcare Provider Details

I. General information

NPI: 1245103274
Provider Name (Legal Business Name): DESCHON COYLE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2025
Last Update Date: 10/27/2025
Certification Date: 10/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 FEDERAL ST
CAMDEN NJ
08103-1539
US

IV. Provider business mailing address

443 PENN BLVD
WOODBURY NJ
08096-2821
US

V. Phone/Fax

Practice location:
  • Phone: 856-583-2400
  • Fax: 856-481-0365
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06552400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: