Provider Demographics
NPI:1578384269
Name:COEN-PICKENS, JAMIE
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:COEN-PICKENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 ORRS LN
Mailing Address - Street 2:
Mailing Address - City:TRIADELPHIA
Mailing Address - State:WV
Mailing Address - Zip Code:26059-1455
Mailing Address - Country:US
Mailing Address - Phone:304-547-9197
Mailing Address - Fax:
Practice Address - Street 1:40 ORRS LN
Practice Address - Street 2:
Practice Address - City:TRIADELPHIA
Practice Address - State:WV
Practice Address - Zip Code:26059-1455
Practice Address - Country:US
Practice Address - Phone:304-693-2511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)