Provider Demographics
NPI:1245879121
Name:COASTAL COUNSELING, LLC
Entity type:Organization
Organization Name:COASTAL COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORMA KAY
Authorized Official - Middle Name:C
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-439-1775
Mailing Address - Street 1:88472 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:OR
Mailing Address - Zip Code:97439-9106
Mailing Address - Country:US
Mailing Address - Phone:541-782-8870
Mailing Address - Fax:
Practice Address - Street 1:1845 HIGHWAY 126 STE A-11
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:OR
Practice Address - Zip Code:97439-9626
Practice Address - Country:US
Practice Address - Phone:541-782-8870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORMA KAY C WOOD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-25
Last Update Date:2019-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty