Individual provider Active NPI

Lakeshia Evett Coakley

  • Counselor
  • Raleigh, NC
National Provider Identifier
1487720405
Registry record updated Aug 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
3125 Poplarwood CT
Suite 304
Raleigh, NC 27604-1084
Phone
(919) 790-8580
NPI assigned
Nov 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

3125 Poplarwood CT
Suite 304
Raleigh, NC 27604-1084

Mailing address

8300 Riverwind LN
Apt 108
Raleigh, NC 27617-8451
Phone (919) 790-8580

Other identifiers 1

IdentifierTypeStateIssuer
1487720405MedicaidNC

Other names 1

  • Lakeshia Evett Coakley Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240118000467 GA Practitioner - Mental Health Counselor 3072965748 Reassigns benefits to 1 organization
I20240206004436 NC Practitioner - Mental Health Counselor 3072965748 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thriving LaneGroup PAC ID 1355741083, 24 clinicians

Practice addresses (Care Compare)

2801 Buford Hwy NE
Suite T10
Atlanta, GA 30329-2149
Phone (347) 830-7720

4801 Glenwood Ave
Suite 200
Raleigh, NC 27612-3857
Phone (347) 830-7720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19342NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thriving Lane CurrentSince Jan 1, 2024 Accepting new patients
Institute for Family Centered Services Past Accepting new patients

Locations

200 2nd Ave S
St Petersburg, FL 33701
Phone (727) 465-8515

2801 Buford Hwy NE
Ste T10
Brookhaven, GA 30329
Phone (404) 397-8302

4801 Glenwood Ave
Ste 200
Raleigh, NC 27612
Phone (757) 866-2715

Interoperability endpoints

  • Direct secure messaging: thrivinglanellc.lakeshiaecoakley@149897.advancedmd-direct.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343779200000",
    "number": "1487720405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8300 RIVERWIND LN",
            "address_2": "APT 108",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276178451",
            "telephone_number": "919-790-8580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3125 POPLARWOOD CT",
            "address_2": "SUITE 304",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276041084",
            "telephone_number": "919-790-8580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COAKLEY",
        "first_name": "LAKESHIA",
        "middle_name": "EVETT",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2012-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487720405",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAKESHIA",
            "last_name": "COAKLEY",
            "middle_name": "EVETT",
            "credential": "LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.