PHYLLIS IDA COACHMAN LCSWR NPI 1689764953

NPI Information

NPI: 1689764953
Provider Name: PHYLLIS IDA COACHMAN, LCSWR
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
30 3RD AVE
BROOKLYN, NY
ZIP 11217
Phone: (718) 858-4626
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Phyllis Ida Coachman, LCSWR is a mental health counselor in Brooklyn, NY. Phyllis Ida Coachman, LCSWR NPI is 1689764953. 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:

30 3RD AVE
BROOKLYN, NY
ZIP 11217-822
Phone: (718) 858-4626

The enumeration date for this NPI number is 10/14/2006 and was last updated on 7/8/2007.

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	101YM0800X	Counselor	Mental Health	R045079-1	NEW YORK	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	01917757	MEDICAID	NEW YORK
2	162839P	OTHER	NEW YORK	HIP
3	N3L821	OTHER	NEW YORK	EMPIRE BLUE CROSS BLUE SH
4	N3L821	MEDICARE ID-TYPE UNSPECIFIED	NEW YORK
5	P2836968	OTHER	NEW YORK	OXFORD

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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