John David Coyle, LPCC
Individual provider Active NPI Professional Counselor · Grants, NM
NPI 1518277235 · NPPES record last updated May 6, 2011
Key facts
- NPI
- 1518277235
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 3026 (NM)
- Practice address
- 700 E Roosevelt Ave
Grants, NM 87020-2220 - Phone
- (505) 287-2273
- Fax
- (505) 287-2276
- NPI assigned
- Oct 15, 2010
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3026 | NM | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 3026 | NM | Yes |
Addresses
Primary practice location
700 E Roosevelt Ave
Grants, NM 87020-2220
Mailing address
700 E Roosevelt Ave
Grants, NM 87020-2220
Phone (505) 287-2273
Other providers in Grants, NM
- Cibola Specialty Associates
- Cibola Sports and Physical Therapy
- Elven Ray Clemons
- Jolene Colburn
- County of Cibola
- James Woodson Crum
- Paul Cuellar
- Darren Haltom Specialty Partners of NM II, LLC
- David Pitts MD PA
- Monica Davis
All providers in Grants, NM · Professional Counselor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.