Jacqueline Louise Coyle, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW012594 Issued in PA

Practice address

4610 Street Rd
Trevose Corporate Center
Trevose, PA 19053

Phone

(800) 366-0129

Fax

(215) 638-1299

NPI assigned

Apr 4, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacqueline.coyle.1@28623.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Optum Behavioral Care of Connecticut, P.C.

  dba Springfield Behavioral of Pennsylvania

  • Counseling Psychologist
  • Philadelphia, PA
  • NPI 1811778988
  Medicare reassignment NPD
• Springfield Psychological PC

  dba Associates of Springfield Psychological

  • Mental Health Counselor
  • Springfield, PA
  • NPI 1295705317
  NPD
• Optum Behavioral Care of Connecticut, P.C.

  • Clinical Social Worker
  • Providence, RI
  • NPI 1730972944
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414540800000",
    "number": "1093837817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1043 MANOR LANE",
            "city": "SOUTHAMPTON",
            "state": "PA",
            "postal_code": "18966",
            "telephone_number": "610-420-7216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4610 STREET RD",
            "address_2": "TREVOSE CORPORATE CENTER",
            "city": "TREVOSE",
            "state": "PA",
            "postal_code": "19053",
            "telephone_number": "800-366-0129",
            "fax_number": "215-638-1299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYLE",
        "first_name": "JACQUELINE",
        "middle_name": "LOUISE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2014-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW012594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Columbus Laser & Vision Institute
• Comfort Orthotics, LLC
• Community Home Health, Inc
• Cornerstone Caregiving East LLC
• Cornerstone Caregiving East LLC
• CSC Home Health Services LLC
• Vincent Paul Cullen, D.M.D.
• A Norman Dahl, PH.D.
• Abigail Heather Dalton, M.A., BCBA
• Kristina A Depinto

• Clinical Social Worker in Trevose, PA
• Providers in Trevose, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.