Provider Demographics
NPI:1013344597
Name:COAN, CHRISTOPHER C (BA)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:C
Last Name:COAN
Suffix:
Gender:M
Credentials:BA
Other - Prefix:MR
Other - First Name:CHRISTOPHER
Other - Middle Name:CHARLES
Other - Last Name:COAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BA
Mailing Address - Street 1:13 TEMPLE ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-5110
Mailing Address - Country:US
Mailing Address - Phone:617-471-8400
Mailing Address - Fax:
Practice Address - Street 1:13 TEMPLE ST
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-5110
Practice Address - Country:US
Practice Address - Phone:617-471-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor