Provider Demographics
NPI:1740524503
Name:COATES, BODIE WARD (LMFT-S, LCADC, NCC)
Entity type:Individual
Prefix:MR
First Name:BODIE
Middle Name:WARD
Last Name:COATES
Suffix:
Gender:M
Credentials:LMFT-S, LCADC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:769 BASQUE WAY STE 800
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-7934
Mailing Address - Country:US
Mailing Address - Phone:775-434-8418
Mailing Address - Fax:
Practice Address - Street 1:769 BASQUE WAY STE 800
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89706-7934
Practice Address - Country:US
Practice Address - Phone:775-434-8418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-19
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01565-L101YA0400X
NV01312106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)