MEDICARE: JEFFREY DOUGLAS COIRA LCSW-S, LCDC, CST

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	1041C0700X	Clinical Social Worker	105158	TX
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	15589	TX

General Provider Information

NPI Number	:	1639894306
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY DOUGLAS COIRA LCSW-S, LCDC, CST

Provider Business Mailing Address
First Line	:	5528 HOLLY SPRINGS DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-2024
Country	:	US
Telephone Number	:	713-364-4155
Fax Number	:

Provider Business Practice Location Address
First Line	:	303 JACKSON HILL ST FL 2
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77007-7407
Country	:	US
Telephone Number	:	713-364-4155
Fax Number	:

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

Provider Enumeration Date	:	10/05/2022
Last Update Date	:	02/26/2026

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Directions to “ JEFFREY DOUGLAS COIRA LCSW-S, LCDC, CST” Practice Location

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