MEDICARE: AMANDA COKER

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1720916240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA COKER

Provider Business Mailing Address
First Line	:	805 GREEN POND RD # M2
Second Line	:
City	:	ROCKAWAY
State	:	NJ
Zip	:	07866-4504
Country	:	US
Telephone Number	:	828-371-4107
Fax Number	:	828-371-4107

Provider Business Practice Location Address
First Line	:	805 GREEN POND RD # M2
Second Line	:
City	:	ROCKAWAY
State	:	NJ
Zip	:	07866-4504
Country	:	US
Telephone Number	:	828-371-4107
Fax Number	:	828-371-4107

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

Provider Enumeration Date	:	05/13/2026
Last Update Date	:	05/13/2026

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Directions to “ AMANDA COKER ” Practice Location

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