Provider Demographics
NPI:1285984658
Name:COFFELT, AMY (LPC, NCC, CCF-CANDID)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:COFFELT
Suffix:
Gender:F
Credentials:LPC, NCC, CCF-CANDID
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7825 HIGHWAY 6 N
Mailing Address - Street 2:SUITE 102D
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-1700
Mailing Address - Country:US
Mailing Address - Phone:281-961-3552
Mailing Address - Fax:
Practice Address - Street 1:7825 HIGHWAY 6 N
Practice Address - Street 2:SUITE 102D
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-1700
Practice Address - Country:US
Practice Address - Phone:713-701-1820
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-13
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66643101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional