Provider Demographics
NPI:1629733233
Name:COATES, ANASIA LANVI
Entity Type:Individual
Prefix:
First Name:ANASIA
Middle Name:LANVI
Last Name:COATES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1350 LA FRANCE ST NE UNIT B
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-2765
Mailing Address - Country:US
Mailing Address - Phone:443-875-6080
Mailing Address - Fax:
Practice Address - Street 1:1350 LA FRANCE ST NE UNIT B
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30307-2765
Practice Address - Country:US
Practice Address - Phone:443-875-6080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD201971041C0700X
PACW0205141041C0700X
CA873351041C0700X
GACSW0076231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical