| Organization Name: | THE COASTAL CENTER FOR DEVELOPING MINDS |
| NPI Number: | 1164718011 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PHOEBE FULTON TEARE (PRESIDENT) |
| Mailing Address: | 133 Washington St Norwell |
| State: | MA US |
| Postal Code: | 020611755 |
| Phone Number: | 7818783870 |
| Fax Number: | |
| NPI Enumeration Date: | 06/20/2011 |
| NPI Last Update Date: | 06/20/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 4952 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |