Theodora P Coffman, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY 9365 Issued in FL

Practice address

146 2ND St N
Suite 310
St Petersburg, FL 33701-3328

Phone

(727) 251-6874

Fax

(727) 308-1185

NPI assigned

Aug 30, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL, NC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Shoreline Psychological Services, LLC

  • Psychologist
  • St Petersburg, FL
  • NPI 1093257982

  NC

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1440892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1922475599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 2ND ST N",
            "address_2": "SUITE 310",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013328",
            "telephone_number": "727-251-6874",
            "fax_number": "727-308-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 2ND ST N",
            "address_2": "SUITE 310",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013328",
            "telephone_number": "727-251-6874",
            "fax_number": "727-308-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COFFMAN",
        "first_name": "THEODORA",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-30",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY 9365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coexist Doulas, LLC
• Mya Cofer
• Heather Coffel, PT, DPT
• Melinda L Coffman, APN
• Michael C Coffman, PSY.D
• Cogent Healthcare of Jacksonville, LLC
• Brianna Paige Cohen
• Evan Martin Cohen, D.O.
• Jonas M. Cohen, DO
• Oren Cohen, MD

• Psychologist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.