Coffin, Jonathan Webster

Coffin, Jonathan Webster is an individual health care provider with primary practice located at 300 Flynn Ave , Burlington VT 05401-5301. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Coffin, Jonathan Webster can be contacted via phone (802) 488-6100.

Contact Information

Primary practice address
300 Flynn Ave Burlington VT 05401-5301
Phone: (802) 488-6100
Fax: (802) 488-6901
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 000046 Vermont
Behavioral Health & Social Service Providers / Psychologist 103T00000X 047-0000159 Vermont
Behavioral Health & Social Service Providers / Clinical 1041C0700X 089-0000192 Vermont

Profile Details

NPI number 1306922612
LBN Legal business name Coffin, Jonathan Webster
Credentials LICSW, MACP, LADC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 29th, 2006
Last updated Jun 12th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306922612 NPPES
Vermont MEDICAID 1007277

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