Provider Demographics
NPI:1508451196
Name:COYLE, MARIA A (NJ, 37PCOO560600)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:A
Last Name:COYLE
Suffix:
Gender:F
Credentials:NJ, 37PCOO560600
Other - Prefix:MS
Other - First Name:MARIA
Other - Middle Name:A
Other - Last Name:COYLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:99 GORGE RD APT 710
Mailing Address - Street 2:
Mailing Address - City:EDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:07020-1083
Mailing Address - Country:US
Mailing Address - Phone:201-697-5971
Mailing Address - Fax:
Practice Address - Street 1:99 GORGE RD APT 710
Practice Address - Street 2:
Practice Address - City:EDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:07020-1083
Practice Address - Country:US
Practice Address - Phone:201-697-5971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-04
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00560600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional