Individual
MR. JOHN B. COYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMFT. CASAC
Contact information
Practice address
7509 N. BROADWAY (RT. 9), RED HOOK, NY 12571
(845) 206-8815
(845) 758-0608
Mailing address
7509 N. BROADWAY (RT. 9), RED HOOK, NY 12571
(845) 206-8815
(845) 758-0608
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
3356
NY
101YA0400X
Addiction (Substance Use Disorder) Counselor
CREDENTIAL # 3356
NY
106H00000X
Marriage & Family Therapist
000483
NY
106H00000X
Marriage & Family Therapist
Primary
000483-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000483
LMFT
NY
01
—
3356
CASAC
NY
Enumeration date
11/03/2006
Last updated
09/14/2010
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