Bobby Coyne LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

4758 Issued in NM

Legal business name

BOBBY COYNE LLC

Practice address

127 Eastgate Dr
Ste 212 H
Los Alamos, NM 87544-3300

Phone

(505) 661-9700

Fax

(505) 663-0100

NPI assigned

Feb 18, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Robert Joseph Coyne Sr., LISW, LADACNPI 1750520599

Title

Clinical Director

Phone

(505) 661-9700

Specialties & licenses 1

Addresses

Other names 1

• A.D.A.P.T. & Recover Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert Joseph Coyne Sr., LISW, LADAC

  • Clinical Social Worker
  • Los Alamos, NM
  • NPI 1750520599
  NPD (past) Authorized official

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

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234915200000",
    "number": "1124267968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2164 43RD ST",
            "address_2": "STE C",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875441745",
            "telephone_number": "505-661-9700",
            "fax_number": "505-663-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 EASTGATE DR",
            "address_2": "STE 212 H",
            "city": "LOS ALAMOS",
            "state": "NM",
            "postal_code": "875443300",
            "telephone_number": "505-661-9700",
            "fax_number": "505-663-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOBBY COYNE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-18",
        "last_updated": "2009-02-18",
        "status": "A",
        "authorized_official_last_name": "COYNE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "505-661-9700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "LISW, LADAC"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NM",
            "license": "4758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A.D.A.P.T. & Recover",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lesley Mendoza Beltran
• Linda Pike Bennett, LPCC
• Jeanne Monique Beyerle
• Big Dog Solutions LLC
• Erika Bittner, DOM
• Wesley David Boose, M.D.
• Kristin Marilyn Whited Boyd, LPCC
• William Henry Brady III, M.D.
• Dana Brake, DPT
• Rita Brake, M.A. LMHC

• All providers in Los Alamos, NM
• Substance Use Disorder Rehabilitation Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.