| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MARA COYLE | 1770182123 | 2020-10-17 |
Mara Coyle is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1770182123. Registration indicates Mara Coyle is a provider of access to mental health/behavioral health providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor: Mental Health, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Mental Health, Behavioral Health & Social Service Providers) (Counselor, )
| Entity Type | Individual |
| Provider Name | Mara Coyle LPCC ATR |
| Practice Office Address | 1856 BEAM AVE STE 200 MAPLEWOOD, MN US |
| Practice Office Telephone | 6516616550 |
| Practice Office Fax | 6516616551 |
| Mailing Address | 1856 BEAM AVE STE 200 MAPLEWOOD, MN 551091162 US |
| Business Telephone | 6516616550 |
| Business Fax | 6516616551 |
| Code | Practice | License No State |
|---|---|---|
| 101YM0800X PRIMARY | Access to Mental Health/Behavioral Health Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor: Mental Health Behavioral Health/Substance Abuse/Psychiatry Counselor Mental Health Behavioral Health & Social Service Providers Counselor | CC02473
MN |
| 193200000X MULT | Group Code |