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General NPI Number Information
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NPI Number | 1588172621
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Entity Type | Organization
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Legal Business Name | MCLAIN COFFIN COUNSELING, LLC
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Dates
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Enumeration Date | 01/10/2018
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Last Update Date | 01/10/2018
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Provider Practice Location Address
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Address Line | 132 E PUTNAM AVE STE 26A
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City | COS COB
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State | CT
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Zip | 06807-2724
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Country | US
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Telephone | 203-900-4904
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Fax |
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Provider Business Mailing Address
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Address Line | 132 E PUTNAM AVE STE 26A
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City | COS COB
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State | CT
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Zip | 06807-2724
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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 | PSYCHOLOGIST
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Name | DR. MELISSA MCLAIN COFFIN
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Credential | PHD
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Telephone | 203-900-4904
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | 3668
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License Number State | CT
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