Provider Demographics
NPI:1376700716
Name:COFIELD, COLLEEN LYNETTE (LCSW)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:LYNETTE
Last Name:COFIELD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 PRIDE DR STE B
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-9527
Mailing Address - Country:US
Mailing Address - Phone:985-543-4730
Mailing Address - Fax:
Practice Address - Street 1:835 PRIDE DR STE B
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-9527
Practice Address - Country:US
Practice Address - Phone:985-543-4080
Practice Address - Fax:985-543-4090
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA97571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1710164Medicaid
LA1710164Medicaid