Shutic Coates, LCSW-C

Key facts

NPI

1487521159

Entity type

Individual (NPI type 1)

Primary specialty

Mental Health Counselor 101YM0800X

License

22433 (MD)

Practice address

12538 Manor Rd
Glen Arm, MD 21057-9503

Phone

(443) 742-0248

NPI assigned

Oct 18, 2025

Sex

Female

Sole proprietor

No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Coates Freedom Minded Consulting Agency, LLC Mental Health Counselor · Glen Arm, MD · NPI 1356285704
  NPD Authorized official MENTAL HEALTH

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Apr 16, 2026.

{
    "created_epoch": "1760745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776297600000",
    "number": "1487521159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12538 MANOR RD",
            "city": "GLEN ARM",
            "state": "MD",
            "postal_code": "210579503",
            "telephone_number": "443-742-0248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12538 MANOR RD",
            "city": "GLEN ARM",
            "state": "MD",
            "postal_code": "210579503",
            "telephone_number": "443-742-0248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 E Joppa Rd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Towson",
            "state": "MD",
            "postal_code": "212863203",
            "country_code": "US",
            "telephone_number": "410-337-0007",
            "fax_number": "410-337-0071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COATES",
        "first_name": "SHUTIC",
        "name_prefix": "Mrs.",
        "credential": "LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-18",
        "last_updated": "2026-04-16",
        "certification_date": "2026-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "22433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Arm, MD

• Benchmark Therapy, Inc.
• John William Buckley Jr., M.D.
• Amy Burton, MS, CCC-SLP
• Christine Nelson
• Coates Freedom Minded Consulting Agency, LLC
• Hannah Connelly, OTR/L
• Samantha Cromwell, RD, LDN, CDCES
• Barrie Renee Davis, P.T.
• Tracy Diamond-Cromwell, LCSW-C
• Kathleen Marie Eiseman-Brock, MSW, LCSW-C

All providers in Glen Arm, MD · Mental Health Counselor in Maryland