Provider Demographics
NPI:1982923058
Name:COKER, ANNA (MA, LPC, LCAS)
Entity Type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:
Last Name:COKER
Suffix:
Gender:F
Credentials:MA, LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:891 BEREA CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-7303
Mailing Address - Country:US
Mailing Address - Phone:252-333-4569
Mailing Address - Fax:252-338-6433
Practice Address - Street 1:891 BEREA CHURCH RD
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-7303
Practice Address - Country:US
Practice Address - Phone:252-333-4569
Practice Address - Fax:252-338-6433
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-27
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1733101YA0400X
NC7839101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6104564Medicaid