Provider Demographics
NPI:1598241622
Name:COFFEE, DENISE (NCC, CCMHC)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:COFFEE
Suffix:
Gender:F
Credentials:NCC, CCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 WILLIAM HILTON PKWY # B
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2497
Mailing Address - Country:US
Mailing Address - Phone:843-547-0200
Mailing Address - Fax:
Practice Address - Street 1:460 WILLIAM HILTON PKWY
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926
Practice Address - Country:US
Practice Address - Phone:843-540-3587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor