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General NPI Number Information
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NPI Number | 1568886737
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Entity Type | Individual
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Provider Name | BROOKE COYNE LCSW
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Gender | Female
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Dates
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Enumeration Date | 02/09/2014
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Last Update Date | 03/05/2025
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Provider Practice Location Address
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Address Line | 1201 ALHAMBRA BLVD
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City | SACRAMENTO
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State | CA
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Zip | 95816-5238
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Country | US
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Telephone | 916-733-5098
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Fax | 724-299-8964
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Provider Business Mailing Address
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Address Line | PO BOX 255228
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City | SACRAMENTO
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State | CA
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Zip | 95865-5228
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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 |
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Name |
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Credential |
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Telephone |
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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 | CW018283
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 112034
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License Number State | CA
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