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Contact Information

DERRELL COAKLEY SR
1315 MILSTEAD RD NE
CONYERS, GA30012-3824
 Phone: 443-225-1210
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Social Worker

104100000X
 

Addiction (Substance Use Disorder)

101YA0400X
Indicates primary specialty

NPI Profile & details for DERRELL COAKLEY SR · (Male)

NPI Number 1861259772
Status Active
Credentials
Entity Individual
Enumeration date 03/06/2024
Last updated 03/06/2024 - About 2 years ago
Sole proprietor 1 Yes
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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