Healthcare Provider Details

I. General information

NPI: 1235050097
Provider Name (Legal Business Name): CAITLIN MARIE COE PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 MADISON AVE
NEW YORK NY
10029-6514
US

IV. Provider business mailing address

4 W 109TH ST APT 6D
NEW YORK NY
10025-2679
US

V. Phone/Fax

Practice location:
  • Phone: 617-512-6870
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number028264
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: