Provider Demographics
NPI:1881833226
Name:COATES, BARRY DOUGLAS SR (MA, LMHP, NCC)
Entity Type:Individual
Prefix:MR
First Name:BARRY
Middle Name:DOUGLAS
Last Name:COATES
Suffix:SR
Gender:M
Credentials:MA, LMHP, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3483 LARIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68111-2383
Mailing Address - Country:US
Mailing Address - Phone:402-455-8303
Mailing Address - Fax:402-455-7050
Practice Address - Street 1:3483 LARIMORE AVE
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68111-2383
Practice Address - Country:US
Practice Address - Phone:402-455-8303
Practice Address - Fax:402-455-7050
Is Sole Proprietor?:No
Enumeration Date:2009-02-09
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2469101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health