Austin, Autumn Coan
Austin, Autumn Coan is an sole proprietor health care provider with primary practice located at 1135 Four Lakes Dr Suite A, Matthews NC 28105-1721. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Austin, Autumn Coan can be contacted via phone (704) 651-0668.Contact Information
Primary practice address
1135 Four Lakes Dr Suite A
Matthews NC 28105-1721
Phone: (704) 651-0668
Fax: (704) 849-0883
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 1926 | North Carolina |
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 4817 | North Carolina |
Profile Details
| NPI number | 1699751107 |
|---|---|
| LBN Legal business name | Austin, Autumn Coan |
| Credentials | MA, LPC, CSAC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 16th, 2005 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1699751107 | NPPES |
| North Carolina | Other | 9388174 | PRIVATE HEALTH CARE SYST |
| North Carolina | Other | 1398G | PRIVATE HEALTH CARE SYST |
| North Carolina | Other | 7167747 | PRIVATE HEALTH CARE SYST |
| North Carolina | Other | 184537 | PRIVATE HEALTH CARE SYST |
| North Carolina | MEDICAID | 6102931 | PRIVATE HEALTH CARE SYST |
| North Carolina | MEDICAID | 6102580 | PRIVATE HEALTH CARE SYST |
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