MEDICARE: ANASIA LANVI COATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	20197	MD
2	1041C0700X	Clinical Social Worker	CW020514	PA
3	1041C0700X	Clinical Social Worker	87335	CA
4	1041C0700X	Clinical Social Worker	CSW007623	GA

General Provider Information

NPI Number	:	1629733233
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANASIA LANVI COATES

Provider Business Mailing Address
First Line	:	1350 LA FRANCE ST NE UNIT B
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30307-2765
Country	:	US
Telephone Number	:	443-875-6080
Fax Number	:

Provider Business Practice Location Address
First Line	:	1350 LA FRANCE ST NE UNIT B
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30307-2765
Country	:	US
Telephone Number	:	443-875-6080
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/08/2021
Last Update Date	:	11/08/2021

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Directions to “ ANASIA LANVI COATES ” Practice Location

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