Phillip Michael Coco, LAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LAC #798 Issued in LA

Practice address

401 Rainbow Dr Unit 6
Pineville, LA 71360-6979

Phone

(318) 484-2168

Fax

(318) 487-5453

NPI assigned

Aug 18, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265241600000",
    "number": "1306950449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 MAIN ST",
            "city": "MOREAUVILLE",
            "state": "LA",
            "postal_code": "713552502",
            "telephone_number": "318-487-5191",
            "fax_number": "318-487-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 RAINBOW DR UNIT 6",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713606979",
            "telephone_number": "318-484-2168",
            "fax_number": "318-487-5453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCO",
        "first_name": "PHILLIP",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2010-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "LA",
            "license": "LAC #798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "G9759",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christus Health Central Louisiana
• Theresa Clark
• Cloud Pediatrics
• Mandie Cloud, PNP
• Jennifer Coburn, RD
• Jacqueline N Cole, LAC
• Joy B Cole, OTA
• Allyn J Coleman, DMD, MS
• Wayne Carlton Coleman, C.A.T.
• Gaylord Collins, CP

• Addiction (Substance Use Disorder) Counselor in Pineville, LA
• Providers in Pineville, LA by specialty
• Addiction (Substance Use Disorder) Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.