Coakley, Derrell

Coakley, Derrell is an sole proprietor health care provider with primary practice located at 1315 Milstead Rd Ne , Conyers GA 30012-3824. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Social Worker is his primary health care specialty. Coakley, Derrell can be contacted via phone (443) 225-1210.

Contact Information

Primary practice address
1315 Milstead Rd Ne Conyers GA 30012-3824
Phone: (443) 225-1210
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Social Worker 104100000X

Profile Details

NPI number 1861259772
LBN Legal business name Coakley, Derrell
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 6th, 2024
Last updated Mar 6th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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