MEDICARE: HENRY N COFFIELD PMHNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	L8-0010317	DE
4	101Y00000X	Counselor	Q1-0001180	DE

General Provider Information

NPI Number	:	1518265487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HENRY N COFFIELD PMHNP-BC

Provider Business Mailing Address
First Line	:	227 N VAN BUREN ST
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19805-3672
Country	:	US
Telephone Number	:	302-507-3532
Fax Number	:

Provider Business Practice Location Address
First Line	:	227 N VAN BUREN ST
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19805-3672
Country	:	US
Telephone Number	:	302-507-3532
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2011
Last Update Date	:	09/18/2024

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