Individual
AUTUMN COAN AUSTIN I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LPC, CSAC
Contact information
Practice address
1135 FOUR LAKES DR, SUITE A, MATTHEWS, NC 28105-1721
(704) 651-0668
(704) 849-0883
Mailing address
2030 BONANZA RD, MONROE, NC 28110-8969
(704) 225-7550
(704) 849-0883
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1926
NC
101YP2500X
Professional Counselor
4817
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1398G
BCBS
NC
01
—
184537
MEDCOST
NC
05
—
6102580
—
NC
05
—
6102931
—
NC
01
—
7167747
AETNA
NC
01
—
9388174
PRIVATE HEALTH CARE SYST
NC
Enumeration date
12/16/2005
Last updated
09/11/2025
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