| Coastal Family Counseling, Llc | |
|
150 Butler Ave Ste D-3 Midway Mini Mall Midway GA 31320-4575 | |
| (912) 442-0558 | |
| Not Available |
| Full Name | Coastal Family Counseling, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 150 Butler Ave Ste D-3, Midway, Georgia |
| Authorized Official Name and Position | Josephine Coleman (OWNER/THERAPIST) |
| Authorized Official Contact | 9124420558 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Family Counseling, Llc 191 Oak Island Dr Midway GA 31320-6923 Ph: (912) 442-0558 | Coastal Family Counseling, Llc 150 Butler Ave Ste D-3 Midway Mini Mall Midway GA 31320-4575 Ph: (912) 442-0558 |
| NPI Number | 1013346816 |
|---|---|
| Provider Enumeration Date | 11/02/2013 |
| Last Update Date | 11/02/2013 |
| Medicare PECOS PAC ID | 0941438428 |
|---|---|
| Medicare Enrollment ID | O20140107001109 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013346816 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | CSW003091 (Georgia) | Primary |
| Provider Name | Josephine C. Coleman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669540548 PECOS PAC ID: 5395973879 Enrollment ID: I20140107001162 |
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