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NPI Code Detail

MEDICARE: JARRED JAMES COFFMAN

MEDICARE: JARRED JAMES COFFMAN
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
1101YM0800XMental Health CounselorOK

General Provider Information

NPI Number : 1699643080
Entity Type Code : Individual
Provider Name (Legal Business Name) : JARRED JAMES COFFMAN
Provider Business Mailing Address
First Line : 109 ROBIN LN
Second Line :
City : TECUMSEH
State : OK
Zip : 74873-1418
Country : US
Telephone Number : 405-605-4249
Fax Number :
Provider Business Practice Location Address
First Line : 602 N BROADWAY ST
Second Line :
City : TECUMSEH
State : OK
Zip : 74873-2020
Country : US
Telephone Number : 405-695-9120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2025
Last Update Date : 10/27/2025

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