Coenen, Craig Patrick

Coenen, Craig Patrick is an individual health care provider with primary practice located at 2053 S Waverly Ave Ste D , Springfield MO 65804-2497. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Coenen, Craig Patrick can be contacted via phone (417) 315-4962.

Contact Information

Primary practice address
2053 S Waverly Ave Ste D Springfield MO 65804-2497
Phone: (417) 315-4962
Fax: (888) 884-4101
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 2010024663 Missouri
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2016035928 Missouri

Profile Details

NPI number 1821137159
LBN Legal business name Coenen, Craig Patrick
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2007
Last updated Oct 16th, 2017 - about 8 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1821137159 NPPES
Missouri MEDICAID 499955409

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