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Individual

ALYSSA COAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW

Contact information

Practice address
1315 FIDDLER AVE., MERRITT ISLAND, FL 32952-3295
(719) 373-7777
Mailing address
1315 FIDDLER AVE, MERRITT ISLAND, FL 32952-5736
(719) 373-9777

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
1041C0700X
Clinical Social Worker
Primary
0904017212
VA
1041C0700X
Clinical Social Worker
130058
IA
1041C0700X
Clinical Social Worker
3571645
ID
1041C0700X
Clinical Social Worker
4857
FL
106S00000X
Behavior Technician

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
802-049-457
CFARS
FL
01
805-043-931
FARS
FL
Enumeration date
09/27/2018
Last updated
01/30/2026
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