Andrew Dean Coffin, CADC

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Jackson, MS

NPI 1609198092 · NPPES record last updated Feb 25, 2010

Key facts

NPI
1609198092
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
500 D East Woodrow Wilson Avenue
Magnolia Addiction Treatment Services
Jackson, MS 39216-4538
Phone
(601) 896-0349
Fax
(601) 362-3339
NPI assigned
Feb 25, 2010
Sex
Male
Sole proprietor
No

Organizations & group practices 1

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

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Addiction Treatment Services Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

500 D East Woodrow Wilson Avenue
Magnolia Addiction Treatment Services
Jackson, MS 39216-4538

Mailing address

500 D East Woodrow Wilson Avenue
Magnolia Addiction Treatment Services
Jackson, MS 39216-4538
Phone (601) 896-0349

Other providers in Jackson, MS

All providers in Jackson, MS · Addiction (Substance Use Disorder) Counselor in Mississippi

Sources for this page

Verify at the official NPI Registry.