Ebone Coakley, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW004856 Issued in GA

Practice address

1840 Old Norcross Rd
Suite 200
Lawrenceville, GA 30044-8803

Phone

(770) 355-6073

Fax

(770) 913-8027

NPI assigned

Sep 22, 2015

Sex

Female

Sole proprietor

Yes

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

Enrolled in GA

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 1

Specialty

Clinical Social Worker

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Total Family and Life Services, LLC

  • Clinical Social Worker
  • Loganville, GA
  • NPI 1164895470
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472601600000",
    "number": "1992174817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "519 HARMONYVIEW CT",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300526233",
            "telephone_number": "770-355-6073",
            "fax_number": "770-913-8027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 OLD NORCROSS RD",
            "address_2": "SUITE 200",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300448803",
            "telephone_number": "770-355-6073",
            "fax_number": "770-913-8027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COAKLEY",
        "first_name": "EBONE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-22",
        "last_updated": "2016-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW004856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003168454B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clinica Union, Inc
• Clio Laboratories, LLC
• Clouds Management LLC
• CLS Counseling and Consulting LLC
• Amber Latrice Coachman, LPC
• Carnita Cobb, LMSW
• Deborah Cobb, P.T
• Scott K Cochrane, DC
• Code 3 Medical Transport
• Susan G Coe, MD

• Clinical Social Worker in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.