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General NPI Number Information
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NPI Number | 1871004002
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Entity Type | Organization
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Legal Business Name | COUGHLIN COUNSELING LLC
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Dates
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Enumeration Date | 10/16/2017
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Last Update Date | 10/16/2017
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Provider Practice Location Address
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Address Line | 98 NORTH AVE STE 1
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City | WEBSTER
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State | NY
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Zip | 14580-3041
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Country | US
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Telephone | 585-315-6674
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Fax | 585-671-7992
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Provider Business Mailing Address
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Address Line | 98 NORTH AVE STE 1
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City | WEBSTER
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State | NY
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Zip | 14580-3041
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Country | US
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Telephone | 585-315-6674
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Fax | 585-671-7992
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | NANCY MONAGHAN COUGHLIN
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Credential | LCSW-R
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Telephone | 585-315-6674
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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 | 0
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License Number State | NY
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