Organization Name: | COASTAL FAMILY COUNSELING, LLC |
NPI Number: | 1013346816 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPHINE COLEMAN (OWNER/THERAPIST) |
Mailing Address: | 150 Butler Ave Ste D-3 Midway Mini Mall Midway |
State: | GA US |
Postal Code: | 313204575 |
Phone Number: | 9124420558 |
Fax Number: | |
NPI Enumeration Date: | 11/02/2013 |
NPI Last Update Date: | 11/02/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | CSW003091 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |