Provider Demographics
NPI:1508961293
Name:COYLE PSYCHOLOGICAL ASSOCIATES LLC
Entity type:Organization
Organization Name:COYLE PSYCHOLOGICAL ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR, PH,D.
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:COYLE
Authorized Official - Suffix:
Authorized Official - Credentials:PH, D,
Authorized Official - Phone:860-928-2119
Mailing Address - Street 1:123 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-5950
Mailing Address - Country:US
Mailing Address - Phone:860-942-1561
Mailing Address - Fax:
Practice Address - Street 1:123 BROADWAY
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-5950
Practice Address - Country:US
Practice Address - Phone:860-942-1561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-14
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004254570Medicaid