Provider Demographics
NPI:1518166958
Name:COATES, ALYSSA CELLA (LCSW)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:CELLA
Last Name:COATES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3311 NW 15TH LN
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33993-9208
Mailing Address - Country:US
Mailing Address - Phone:804-814-7715
Mailing Address - Fax:
Practice Address - Street 1:3311 NW 15TH LN
Practice Address - Street 2:
Practice Address - City:CAPE CORAL
Practice Address - State:FL
Practice Address - Zip Code:33993-9208
Practice Address - Country:US
Practice Address - Phone:804-814-7715
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-16
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040045421041C0700X
FLSW180971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical