| Coastal Collaborative Care Llc | |
|
2121 Eisenhower Ave Ste 200 Alexandria VA 22314-4688 | |
| (571) 249-5332 | |
| Not Available |
| Full Name | Coastal Collaborative Care Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 2121 Eisenhower Ave Ste 200, Alexandria, Virginia |
| Authorized Official Name and Position | Gabrielle Katz (FOUNDER) |
| Authorized Official Contact | 5712495332 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Collaborative Care Llc 2121 Eisenhower Ave Ste 200 Alexandria VA 22314-4688 Ph: (571) 249-5332 | Coastal Collaborative Care Llc 2121 Eisenhower Ave Ste 200 Alexandria VA 22314-4688 Ph: (571) 249-5332 |
| NPI Number | 1013506310 |
|---|---|
| Provider Enumeration Date | 01/12/2021 |
| Last Update Date | 11/24/2021 |
| Certification Date | 11/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013506310 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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