| Coastal Behavioral Health Llc | |
|
1650 Ne 26th St Ste 201 Wilton Manors FL 33305-1431 | |
| (954) 271-3397 | |
| (954) 947-3028 |
| Full Name | Coastal Behavioral Health Llc |
|---|---|
| Speciality | Psychologist |
| Location | 1650 Ne 26th St Ste 201, Wilton Manors, Florida |
| Authorized Official Name and Position | Toni Richardi (OWNER) |
| Authorized Official Contact | 9542713397 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Behavioral Health Llc 1650 Ne 26th St Ste 201 Wilton Manors FL 33305-1431 Ph: (954) 271-3397 | Coastal Behavioral Health Llc 1650 Ne 26th St Ste 201 Wilton Manors FL 33305-1431 Ph: (954) 271-3397 |
| NPI Number | 1184095762 |
|---|---|
| Provider Enumeration Date | 10/08/2015 |
| Last Update Date | 09/10/2018 |
| Medicare PECOS PAC ID | 2264734227 |
|---|---|
| Medicare Enrollment ID | O20160107001286 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184095762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PY 9346 (Florida) | Primary |
| Provider Name | Toni M Richardi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295111623 PECOS PAC ID: 3173825130 Enrollment ID: I20180705000518 |
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