Provider Demographics
NPI:1679939656
Name:COATES, TEMITOPE SHAKIRAT (LCSW, LCADC)
Entity Type:Individual
Prefix:
First Name:TEMITOPE
Middle Name:SHAKIRAT
Last Name:COATES
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:TEMITOPE
Other - Middle Name:SHAKIRAT
Other - Last Name:COATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, LCADC, CCS
Mailing Address - Street 1:654 MOUNT PROSPECT AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07104-3110
Mailing Address - Country:US
Mailing Address - Phone:973-878-3900
Mailing Address - Fax:973-878-3809
Practice Address - Street 1:654 MOUNT PROSPECT AVE STE 201
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07104-3110
Practice Address - Country:US
Practice Address - Phone:862-888-8146
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-06
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00242600101YA0400X
NJ44SC05667800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)