Provider Demographics
NPI:1407373491
Name:COFFMAN, JESSICA (MS, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:COFFMAN
Suffix:
Gender:F
Credentials:MS, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4548 KELLER RD
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:OH
Mailing Address - Zip Code:43025-9404
Mailing Address - Country:US
Mailing Address - Phone:740-641-5020
Mailing Address - Fax:
Practice Address - Street 1:209 SENECA AVE
Practice Address - Street 2:
Practice Address - City:BYESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43723-1364
Practice Address - Country:US
Practice Address - Phone:740-685-1610
Practice Address - Fax:740-685-1610
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-29
Last Update Date:2017-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health