Provider Demographics
NPI:1396311064
Name:COATS, MELISSA (LAC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:COATS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:DENNING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3737 S ELIZABETH ST STE 104
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-1717
Mailing Address - Country:US
Mailing Address - Phone:913-710-3565
Mailing Address - Fax:816-817-6595
Practice Address - Street 1:3737 S ELIZABETH ST STE 104
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-1717
Practice Address - Country:US
Practice Address - Phone:913-710-3565
Practice Address - Fax:816-817-6595
Is Sole Proprietor?:No
Enumeration Date:2021-06-02
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022034546101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor