| Coastal Counseling Center Inc | |
|
809 Kent Place Chesapeake VA 23320-0768 | |
| (757) 436-0605 | |
| (757) 436-0023 |
| Full Name | Coastal Counseling Center Inc |
|---|---|
| Speciality | Counselor |
| Location | 809 Kent Place, Chesapeake, Virginia |
| Authorized Official Name and Position | Elisabeth Pesce (PRESIDENT) |
| Authorized Official Contact | 9046054986 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Counseling Center Inc 809 Kent Place Suite 260 Chesapeake VA 23320-0768 Ph: (757) 436-0605 | Coastal Counseling Center Inc 809 Kent Place Chesapeake VA 23320-0768 Ph: (757) 436-0605 |
| NPI Number | 1639264112 |
|---|---|
| Provider Enumeration Date | 10/03/2006 |
| Last Update Date | 03/21/2023 |
| Certification Date | 03/21/2023 |
| Medicare PECOS PAC ID | 7012997380 |
|---|---|
| Medicare Enrollment ID | O20040726000886 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639264112 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Robin M Shelton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801867247 PECOS PAC ID: 9931202256 Enrollment ID: I20070307000110 |
| Provider Name | Judith Griffin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730258328 PECOS PAC ID: 4880750900 Enrollment ID: I20090225000458 |
| Provider Name | Mary C Brantley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538364179 PECOS PAC ID: 1254514342 Enrollment ID: I20110328000440 |
| Provider Name | Ronna B Adler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598717068 PECOS PAC ID: 4183898612 Enrollment ID: I20111119000123 |
| Provider Name | Samantha L Zbur |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558740381 PECOS PAC ID: 2860767035 Enrollment ID: I20171013002990 |
| Provider Name | Marcella R Bowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003329020 PECOS PAC ID: 6204196207 Enrollment ID: I20180213001723 |
| Provider Name | Demetrous J Johnston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407460413 PECOS PAC ID: 4082026125 Enrollment ID: I20201215002067 |
| Provider Name | Brooks Hamilton Gale |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417608936 PECOS PAC ID: 2062808355 Enrollment ID: I20220414000279 |
| Provider Name | Robyn Hilbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376204685 PECOS PAC ID: 0941670962 Enrollment ID: I20230106002075 |
| Provider Name | Maddison C Schiafo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528770740 PECOS PAC ID: 5395101034 Enrollment ID: I20230522003386 |
| Provider Name | Olivia N Bonanno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720564735 PECOS PAC ID: 4082965827 Enrollment ID: I20231026001150 |
| Provider Name | Ebony Shanay Canady |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093173528 PECOS PAC ID: 0446608194 Enrollment ID: I20240325000395 |
| Provider Name | Linda Jean Thimons |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144475849 PECOS PAC ID: 7719338508 Enrollment ID: I20240325001524 |
| Provider Name | Shauna Jeanette Polen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457139792 PECOS PAC ID: 6002253101 Enrollment ID: I20240325003974 |
| Provider Name | John S. Copeland |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083602387 PECOS PAC ID: 9436596491 Enrollment ID: I20240326002364 |
| Provider Name | Charlotta Amelia Crews |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285363796 PECOS PAC ID: 8729426416 Enrollment ID: I20240401000485 |
| Provider Name | Renee Marie Skinner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1598318909 PECOS PAC ID: 2264871938 Enrollment ID: I20240414000015 |
| Provider Name | Jenelle Monet Drake |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134674971 PECOS PAC ID: 5890134274 Enrollment ID: I20240418000337 |
| Provider Name | Jennifer Lynn Erickson |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1497101620 PECOS PAC ID: 4082053335 Enrollment ID: I20240418003341 |
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