Coffee Clutch Counseling Services, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

COFFEE CLUTCH COUNSELING SERVICES, LLC

Practice address

2151 Lafayette Ave Ste 105
Terre Haute, IN 47805-2910

Phone

(315) 408-9379

Fax

(561) 282-3238

NPI assigned

Jan 22, 2019

Organization subpart

No

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

Authorized official

Name

Rebecca ChambersNPI 1033366638

Title

Owner

Phone

(315) 408-9379

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 3

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

• Rebecca Chambers, LCSW; CADC

  • Clinical Social Worker
  • Elizabethtown, KY
  • NPI 1033366638

  Addiction (Substance Use Disorder), IN

  Medicare reassignment NPD Authorized official
• Rosita M Fernandez

  • Psychologist
  • Burlington, WI
  • NPI 1376062851

  IN

  Medicare reassignment NPD
• Amanda Rae Lee, MSW, LSW

  • Clinical Social Worker
  • Terre Haute, IN
  • NPI 1982200986
  NPD

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551398400000",
    "number": "1477027696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 LAFAYETTE AVE STE 105",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478052910",
            "telephone_number": "315-408-9379",
            "fax_number": "561-282-3238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2151 LAFAYETTE AVE STE 105",
            "city": "TERRE HAUTE",
            "state": "IN",
            "postal_code": "478052910",
            "telephone_number": "315-408-9379",
            "fax_number": "561-282-3238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COFFEE CLUTCH COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-22",
        "last_updated": "2019-03-01",
        "status": "A",
        "authorized_official_last_name": "CHAMBERS",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-408-9379"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krystina Cobb, DDS
• Taylor Cochonour
• Lauren Cochran, PA
• Cierra Cockrell, RBT
• Sara Louise Coe, NP
• Megan Helen Coffer, NP
• Daniel Mark Coffey, ATC
• George Michael Coffin, PSY.D.
• Erika Cole, RBT
• Cayla Coleman, LSW

• Clinical Social Worker in Terre Haute, IN
• Providers in Terre Haute, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.