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General NPI Number Information
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NPI Number | 1124829643
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Entity Type | Organization
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Legal Business Name | INSPIRING WELLNESS PRIVATE PRACTICE UNDER NICOLE L COOGAN LCSW PLLC
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 186 W MAIN ST UNIT 3
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City | SAYVILLE
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State | NY
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Zip | 11782-2528
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Country | US
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Telephone | 631-513-1059
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Fax |
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Provider Business Mailing Address
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Address Line | 50 GARFIELD AVE
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City | SAYVILLE
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State | NY
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Zip | 11782-2611
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/CLINICAL SOCIAL WORKER
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Name | NICOLE COOGAN
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Credential | LCSW
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Telephone | 631-513-1059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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