Provider Demographics
NPI:1780822148
Name:COAKLEY, DONNA CECILIA (LCPC)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:CECILIA
Last Name:COAKLEY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:MRS
Other - First Name:DONNA
Other - Middle Name:HUDSON
Other - Last Name:COAKLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC
Mailing Address - Street 1:77 H ST NW APT 151
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-2336
Mailing Address - Country:US
Mailing Address - Phone:301-908-9236
Mailing Address - Fax:
Practice Address - Street 1:216 MICHIGAN AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-1095
Practice Address - Country:US
Practice Address - Phone:202-877-7943
Practice Address - Fax:855-778-6874
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-22
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC0875101YM0800X
DCPRC1370101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health