Provider Demographics
NPI:1134610850
Name:MCDERMOTT-COFFIN, CATHERINE (PSYD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:MCDERMOTT-COFFIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 WOOD RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10507-1205
Mailing Address - Country:US
Mailing Address - Phone:914-244-1656
Mailing Address - Fax:
Practice Address - Street 1:110 WOOD RD
Practice Address - Street 2:
Practice Address - City:BEDFORD HILLS
Practice Address - State:NY
Practice Address - Zip Code:10507-1205
Practice Address - Country:US
Practice Address - Phone:914-244-1656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016459103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical