Provider Demographics
NPI:1528506078
Name:COY, NATASHA (PSYD)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:COY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 GREENWOOD AVENUE
Mailing Address - Street 2:
Mailing Address - City:CLARKS SUMMIT
Mailing Address - State:PA
Mailing Address - Zip Code:18411
Mailing Address - Country:US
Mailing Address - Phone:570-218-2402
Mailing Address - Fax:570-227-0934
Practice Address - Street 1:203 GREENWOOD AVE
Practice Address - Street 2:
Practice Address - City:CLARKS SUMMIT
Practice Address - State:PA
Practice Address - Zip Code:18411-1405
Practice Address - Country:US
Practice Address - Phone:570-218-2402
Practice Address - Fax:570-227-0934
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-04
Last Update Date:2022-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS018142103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical