Provider Demographics
NPI:1336222462
Name:COFFIN, JULIA BARNHARDT (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:BARNHARDT
Last Name:COFFIN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 BROAD ST STE 5
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37408-3067
Mailing Address - Country:US
Mailing Address - Phone:423-509-8004
Mailing Address - Fax:
Practice Address - Street 1:2601 BROAD ST STE 5
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408
Practice Address - Country:US
Practice Address - Phone:423-509-8004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1150171041C0700X
NCC0064081041C0700X
TN65391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical