Provider Demographics
NPI:1811102601
Name:COATES, BOBBY LLOYD (LMHC, LPC, LMFT)
Entity type:Individual
Prefix:MR
First Name:BOBBY
Middle Name:LLOYD
Last Name:COATES
Suffix:
Gender:M
Credentials:LMHC, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4520 W OAKELLAR AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33611-3114
Mailing Address - Country:US
Mailing Address - Phone:813-833-0162
Mailing Address - Fax:888-805-1859
Practice Address - Street 1:3005 W EUCLID AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-8954
Practice Address - Country:US
Practice Address - Phone:813-508-1859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-14
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001421101YP2500X
TNMFT158106H00000X
FLMH16746101YM0800X
TNMFT 158106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VALPC0701001421OtherBEHAVIORAL PAIN MANAGEMENT
TNLPC321OtherBEHAVIOR PAIN MANAGEMENT
TNMFT53OtherBEHAVIORAL PAIN MANAGEMENT
FLMH16746OtherBEHAVIORAL PAIN MANAGEMENT