Provider Demographics
NPI:1104159128
Name:COFFEY, CATHERINE (MAMFTC, LPC)
Entity type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:
Last Name:COFFEY
Suffix:
Gender:F
Credentials:MAMFTC, LPC
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1635 LELIA DR.
Mailing Address - Street 2:SUITE 100
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4876
Mailing Address - Country:US
Mailing Address - Phone:601-362-7020
Mailing Address - Fax:601-809-4233
Practice Address - Street 1:1635 LELIA DR.
Practice Address - Street 2:SUITE 100
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4876
Practice Address - Country:US
Practice Address - Phone:601-362-7020
Practice Address - Fax:601-809-4233
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1465101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional