Judith Ann Coyle, LMHC,LMFT

Individual provider Active NPI Mental Health Counselor · South Weymouth, MA

NPI 1497848907 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1497848907
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
1077 (MA)
Practice address
172 Union Street
South Weymouth, MA 02190-2853
Phone
(781) 337-8409
Fax
(508) 895-9990
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
538MAMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1077 MA Yes
Mental Health Counselor 101YM0800X 538 MA

Addresses

Primary practice location

172 Union Street
South Weymouth, MA 02190-2853

Mailing address

172 Union Street
South Weymouth, MA 02190-2853
Phone (781) 337-8409

Other identifiers

IdentifierTypeStateIssuer
LM0008OtherMABC/BS
768530OtherMATUFTS

Other providers in South Weymouth, MA

All providers in South Weymouth, MA · Mental Health Counselor in Massachusetts

Sources for this page

Verify at the official NPI Registry.