Provider Demographics
NPI:1215419866
Name:COYLE, AMBER (LPCC)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:COYLE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:COYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AMBER PROFFITT
Mailing Address - Street 1:614 JACKSBORO ST
Mailing Address - Street 2:
Mailing Address - City:FERGUSON
Mailing Address - State:KY
Mailing Address - Zip Code:42533-9555
Mailing Address - Country:US
Mailing Address - Phone:606-687-1427
Mailing Address - Fax:
Practice Address - Street 1:614 JACKSBORO ST
Practice Address - Street 2:
Practice Address - City:FERGUSON
Practice Address - State:KY
Practice Address - Zip Code:42533-9555
Practice Address - Country:US
Practice Address - Phone:606-687-1427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-30
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health