Provider Demographics
NPI:1619200839
Name:COATS, MARY HELEN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:HELEN
Last Name:COATS
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 1:2090 HIGHWAY 317 STE A
Mailing Address - Street 2:#276
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-2600
Mailing Address - Country:US
Mailing Address - Phone:404-213-0885
Mailing Address - Fax:
Practice Address - Street 1:2090 HIGHWAY 317 STE A
Practice Address - Street 2:#276
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-2600
Practice Address - Country:US
Practice Address - Phone:404-213-0885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005607101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional