| Coastal Center For Cognitive Therapy, Pa | |
|
1101 Johnson Ave Suite 200 Myrtle Beach SC 29577-1660 | |
| (843) 839-9028 | |
| (843) 839-9029 |
| Full Name | Coastal Center For Cognitive Therapy, Pa |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1101 Johnson Ave, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Michael M. Grant (PRESIDENT/SECRETARY) |
| Authorized Official Contact | 8438399028 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Center For Cognitive Therapy, Pa 1101 Johnson Ave Suite 200 Myrtle Beach SC 29577-1660 Ph: (843) 839-9028 | Coastal Center For Cognitive Therapy, Pa 1101 Johnson Ave Suite 200 Myrtle Beach SC 29577-1660 Ph: (843) 839-9028 |
| NPI Number | 1447436290 |
|---|---|
| Provider Enumeration Date | 01/10/2008 |
| Last Update Date | 03/06/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447436290 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1071 (South Carolina) | Primary |
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