Provider Demographics
NPI:1255677043
Name:COATES-SMITH, LATONIA ANN (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:LATONIA
Middle Name:ANN
Last Name:COATES-SMITH
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 CAVE SPRINGS ESTATE DR
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-6531
Mailing Address - Country:US
Mailing Address - Phone:314-482-6928
Mailing Address - Fax:
Practice Address - Street 1:9666 OLIVE BLVD STE 205
Practice Address - Street 2:
Practice Address - City:OLIVETTE
Practice Address - State:MO
Practice Address - Zip Code:63132-3025
Practice Address - Country:US
Practice Address - Phone:636-344-0158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-24
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20120038701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical