Provider Demographics
NPI:1730338898
Name:COE, SEAN ALAN (LCSW)
Entity type:Individual
Prefix:
First Name:SEAN
Middle Name:ALAN
Last Name:COE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22777 LYONS AVE
Mailing Address - Street 2:SUITE 106A
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91321-2849
Mailing Address - Country:US
Mailing Address - Phone:818-456-3011
Mailing Address - Fax:661-222-7374
Practice Address - Street 1:22777 LYONS AVE
Practice Address - Street 2:SUITE 106A
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91321-2849
Practice Address - Country:US
Practice Address - Phone:818-456-3011
Practice Address - Fax:661-222-7374
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-15
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS273541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA455300421OtherEIN