Provider Demographics
NPI:1780719757
Name:COSTON, IGATHEA J (MSW,GSW)
Entity type:Individual
Prefix:MRS
First Name:IGATHEA
Middle Name:J
Last Name:COSTON
Suffix:
Gender:F
Credentials:MSW,GSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6911 RIDGEFIELD DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70128-2624
Mailing Address - Country:US
Mailing Address - Phone:504-361-6491
Mailing Address - Fax:
Practice Address - Street 1:4422 GENERAL MEYER AVE
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70131-3588
Practice Address - Country:US
Practice Address - Phone:504-361-6491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA61851041C0700X
LA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical