Provider Demographics
NPI:1730397225
Name:LAWLESS COKER, MELINDA A (PSYD, LMFT)
Entity type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:A
Last Name:LAWLESS COKER
Suffix:
Gender:F
Credentials:PSYD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4431 SW 64TH AVE
Mailing Address - Street 2:SUITE 107
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-3458
Mailing Address - Country:US
Mailing Address - Phone:954-797-7430
Mailing Address - Fax:954-797-6782
Practice Address - Street 1:4431 SW 64TH AVE
Practice Address - Street 2:SUITE 107
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-3458
Practice Address - Country:US
Practice Address - Phone:954-797-7430
Practice Address - Fax:954-797-6782
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCAP1406101YA0400X
FLPY7080103TC0700X
FLMT1504106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist