Provider Demographics
NPI:1881370872
Name:COATS, PREYA TARA (LSW)
Entity type:Individual
Prefix:MRS
First Name:PREYA
Middle Name:TARA
Last Name:COATS
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:PREYA
Other - Middle Name:TARA
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:611 E 34TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46205-3720
Mailing Address - Country:US
Mailing Address - Phone:317-945-3522
Mailing Address - Fax:
Practice Address - Street 1:7340 CROSSING PL STE 100
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-2730
Practice Address - Country:US
Practice Address - Phone:463-220-0437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33010665A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker