Provider Demographics
NPI:1518166958
Name:COATES, ALYSSA CELLA (LCSW)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:CELLA
Last Name:COATES
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 1:15000 SHELL POINT BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33908-1657
Mailing Address - Country:US
Mailing Address - Phone:239-454-2146
Mailing Address - Fax:239-454-2079
Practice Address - Street 1:13880 SHELL POINT PLZ STE 110
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908
Practice Address - Country:US
Practice Address - Phone:239-454-2146
Practice Address - Fax:239-454-2111
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2024-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW180971041C0700X
VA09040045421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical