Provider Demographics
NPI:1811584352
Name:COYNE, MICHELLE LEA (LPC-MHSP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LEA
Last Name:COYNE
Suffix:
Gender:F
Credentials:LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8019 OLD CHARLOTTE PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-5403
Mailing Address - Country:US
Mailing Address - Phone:615-982-3710
Mailing Address - Fax:
Practice Address - Street 1:1301 16TH AVENUE SOUTH; 2ND FLOOR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-2923
Practice Address - Country:US
Practice Address - Phone:615-982-3710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000003387101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health