Provider Demographics
NPI:1730257692
Name:JODOIN, ELIZABETH COFFIN (LPC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:COFFIN
Last Name:JODOIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNCG COUNSELING AND TESTING CTR
Mailing Address - Street 2:107 GRAY DRIVE
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27412-0001
Mailing Address - Country:US
Mailing Address - Phone:336-334-5874
Mailing Address - Fax:336-334-3900
Practice Address - Street 1:UNCG COUNSELING AND TESTING CTR
Practice Address - Street 2:107 GRAY DRIVE
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27412-0001
Practice Address - Country:US
Practice Address - Phone:336-334-5874
Practice Address - Fax:336-334-3900
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5202101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103173Medicaid