Provider Demographics
NPI:1457431694
Name:COATES, ROSEMARY ANN (MA, LPC)
Entity Type:Individual
Prefix:
First Name:ROSEMARY
Middle Name:ANN
Last Name:COATES
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2939 W WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78228-5015
Mailing Address - Country:US
Mailing Address - Phone:210-503-4461
Mailing Address - Fax:210-503-4470
Practice Address - Street 1:2939 W WOODLAWN AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78228-5015
Practice Address - Country:US
Practice Address - Phone:210-503-4461
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12077101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX028588404Medicaid
TX028588401Medicaid