Dominique Coffie

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

DOMINIQUE COFFIE

Doing business as

Dominique Coffie

Practice address

6727 175TH St
Tinley Park, IL 60477-4041

Phone

(716) 603-9857

NPI assigned

Oct 1, 2014

Last updated

Oct 1, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dominique Coffie

Title

Mental Health Professional

Phone

(716) 603-9857

Specialties & licenses 1

Addresses

Other names 1

• Dominique Coffie Doing business as

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

{
    "created_epoch": "1412121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412121600000",
    "number": "1962805176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6727 175TH ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604774041",
            "telephone_number": "716-603-9857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6727 175TH ST",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604774041",
            "telephone_number": "716-603-9857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOMINIQUE COFFIE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-01",
        "last_updated": "2014-10-01",
        "status": "A",
        "authorized_official_last_name": "COFFIE",
        "authorized_official_first_name": "DOMINIQUE",
        "authorized_official_title_or_position": "MENTAL HEALTH PROFESSIONAL",
        "authorized_official_telephone_number": "716-603-9857"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dominique Coffie",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Behavioral Health Agency in Tinley Park, IL
• Providers in Tinley Park, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; 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.