| Coastal Haven Counseling Llc | |
|
220 Ronnie Ct Ste 2 Myrtle Beach SC 29579-4192 | |
| (843) 945-0346 | |
| (843) 432-3091 |
| Full Name | Coastal Haven Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 220 Ronnie Ct Ste 2, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Sandra Elaine Quast (LPC) |
| Authorized Official Contact | 8439450346 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Haven Counseling Llc 220 Ronnie Ct Ste 2 Myrtle Beach SC 29579-4192 Ph: (843) 945-0346 | Coastal Haven Counseling Llc 220 Ronnie Ct Ste 2 Myrtle Beach SC 29579-4192 Ph: (843) 945-0346 |
| NPI Number | 1609314293 |
|---|---|
| Provider Enumeration Date | 02/03/2017 |
| Last Update Date | 10/25/2019 |
| Medicare PECOS PAC ID | 2365877008 |
|---|---|
| Medicare Enrollment ID | O20200127001494 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609314293 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | 6522 (South Carolina) | Secondary |
| Provider Name | Carol Ann Fletcher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295952232 PECOS PAC ID: 8426207895 Enrollment ID: I20161219000421 |
| Provider Name | Lester C Robinette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932566817 PECOS PAC ID: 4587902499 Enrollment ID: I20190218002792 |
| Provider Name | Sheena Gaddis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235452772 PECOS PAC ID: 4385071679 Enrollment ID: I20200226001722 |
| Provider Name | Diantha S Bovey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861935405 PECOS PAC ID: 7810278827 Enrollment ID: I20200504002084 |
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