| Doctor Name: | MR. JOHN B. COYLE |
| NPI Number: | 1518046192 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LMFT. CASAC |
| License Number: | CREDENTIAL # 3356 |
| Business Practice Address: | 7509 N. Broadway (rt. 9) Red Hook, NY - 12571 |
| Business Phone Number: | 8452068815 |
| Business Fax Number: | 8457580608 |
| Mailing Address: | 7509 N. Broadway (rt. 9), RED HOOK |
| State: | NY |
| Postal Code: | 12571 |
| Phone Number: | 8452068815 |
| Fax Number: | 8457580608 |
| NPI Enumeration Date: | 11/03/2006 |
| NPI Last Update Date: | 09/14/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | CREDENTIAL # 3356 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |