Provider Demographics
NPI:1275698268
Name:COKER, KAYE HAMES (LCSW)
Entity Type:Individual
Prefix:
First Name:KAYE
Middle Name:HAMES
Last Name:COKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 GRAYMONT DR
Mailing Address - Street 2:
Mailing Address - City:GRAYSON
Mailing Address - State:GA
Mailing Address - Zip Code:30017-1651
Mailing Address - Country:US
Mailing Address - Phone:770-338-7463
Mailing Address - Fax:770-972-2849
Practice Address - Street 1:1244 CLAIRMONT RD
Practice Address - Street 2:SUITE 106
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1259
Practice Address - Country:US
Practice Address - Phone:770-366-5946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0015711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical