Coffman Counseling LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

COFFMAN COUNSELING LLC

Practice address

763 Revere St
Bourbonnais, IL 60914-4563

Phone

(815) 549-0981

NPI assigned

Aug 31, 2021

Organization subpart

No

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

Authorized official

Name

Jared Coffman, LCSWNPI 1174297071

Title

Therapist

Phone

(815) 549-0981

Specialties & licenses 1

Addresses

Practitioners 1

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

• Jared Coffman

  • Clinical Social Worker
  • Bourbonnais, IL
  • NPI 1174297071
  NPD Authorized official

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630368000000",
    "number": "1740958172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "763 REVERE ST",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609144563",
            "telephone_number": "815-549-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 REVERE ST",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "609144563",
            "telephone_number": "815-549-0981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COFFMAN COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A",
        "authorized_official_last_name": "COFFMAN",
        "authorized_official_first_name": "JARED",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "815-549-0981",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Christy
• David Scott Chudwin, M.D.
• Ashley Lynn Cirrencione, ATC
• Citadel of Bourbonnais LLC
• Ericka Clark, LCPC
• Jared Coffman
• Sirous - Cohanim, MD
• Cole Vision Corporation
• Collective Balance Counseling, LLC
• Margaret Comfort, PA

• Mental Health Clinic/Center (Including Community Mental Health Center) in Bourbonnais, IL
• Providers in Bourbonnais, IL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.