JONATHAN WEBSTER COFFIN LICSW MACP LADC NPI 1306922612

NPI Information

NPI: 1306922612
Provider Name: JONATHAN WEBSTER COFFIN, LICSW, MACP, LADC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
300 FLYNN AVE
BURLINGTON, VT
ZIP 05401
Phone: (802) 488-6100
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Jonathan Webster Coffin, LICSW, MACP, LADC is an addiction (substance use disorder) counselor in Burlington, VT. Jonathan Webster Coffin, LICSW, MACP, LADC NPI is 1306922612. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

300 FLYNN AVE
BURLINGTON, VT
ZIP 05401-301
Phone: (802) 488-6100
Fax: (802) 488-6901

The enumeration date for this NPI number is 10/29/2006 and was last updated on 6/12/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	103T00000X	Psychologist		047-0000159	VERMONT	No
2	1041C0700X	Social Worker	Clinical	089-0000192	VERMONT	No
3	101YA0400X	Counselor	Addiction (Substance Use Disorder)	000046	VERMONT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	VN2630	MEDICARE ID-TYPE UNSPECIFIED	VERMONT
2	1007277	MEDICAID	VERMONT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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