Lyle Keith Coalwell, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC002580 Issued in GA

Practice address

6488 Spring St
Suite 102
Douglasville, GA 30134-1895

Phone

(770) 949-1595

Fax

(770) 489-7521

NPI assigned

Jan 2, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Sheltered Cove Counseling Center Inc

  • Professional Counselor
  • Douglasville, GA
  • NPI 1730224874
  NPD (past)

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922165869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6488 SPRING ST",
            "address_2": "SUITE 102",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341895",
            "telephone_number": "770-949-1595",
            "fax_number": "770-489-7521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6488 SPRING ST",
            "address_2": "SUITE 102",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301341895",
            "telephone_number": "770-949-1595",
            "fax_number": "770-489-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COALWELL",
        "first_name": "LYLE",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC002580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Amy Cochran, RBT
• Andre S Cohen, MD

• Professional Counselor in Douglasville, GA
• Providers in Douglasville, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.