Provider Demographics
NPI:1821245481
Name:COFFEY, TAMMI JO (LMFT)
Entity Type:Individual
Prefix:
First Name:TAMMI
Middle Name:JO
Last Name:COFFEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:TAMMI
Other - Middle Name:JO
Other - Last Name:COFFEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCPC
Mailing Address - Street 1:1524 1ST AVE S
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-3805
Mailing Address - Country:US
Mailing Address - Phone:303-709-1112
Mailing Address - Fax:
Practice Address - Street 1:1524 1ST AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3805
Practice Address - Country:US
Practice Address - Phone:303-709-1112
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-25
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1377 LCPC101YM0800X
MT20106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000744870OtherBLUE CROSS-SHIELD OF MONTANA