Provider Demographics
NPI:1093302473
Name:COASTAL MENTAL HEALTH, PLLC
Entity Type:Organization
Organization Name:COASTAL MENTAL HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CASH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-806-2669
Mailing Address - Street 1:103 HARPSWELL RD
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-7842
Mailing Address - Country:US
Mailing Address - Phone:207-806-2669
Mailing Address - Fax:
Practice Address - Street 1:103 HARPSWELL RD
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011-7842
Practice Address - Country:US
Practice Address - Phone:207-806-2669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-31
Last Update Date:2020-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health