Provider Demographics
NPI:1255537809
Name:COUPE, JAMES J III (PSYD, MBA)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:COUPE
Suffix:III
Gender:M
Credentials:PSYD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 LINCOLN CIR
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-1502
Mailing Address - Country:US
Mailing Address - Phone:484-422-8460
Mailing Address - Fax:
Practice Address - Street 1:125 COULTER AVE
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:PA
Practice Address - Zip Code:19003-2410
Practice Address - Country:US
Practice Address - Phone:610-642-4873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015639103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical