Provider Demographics
NPI:1972831907
Name:COATES, YOLANDA REDONA (LPC)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:REDONA
Last Name:COATES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:YOLANDA
Other - Middle Name:WALKER
Other - Last Name:BANJA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:3810 BUFFINGTON PL
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30291-5027
Mailing Address - Country:US
Mailing Address - Phone:404-748-3762
Mailing Address - Fax:470-428-6907
Practice Address - Street 1:3810 BUFFINGTON PL
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:GA
Practice Address - Zip Code:30291-5027
Practice Address - Country:US
Practice Address - Phone:404-748-3762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-02
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7628101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003193773AMedicaid
NC6104370Medicaid