| Coastal Horizons Center, Inc. | |
|
615 Shipyard Blvd Wilmington NC 28412-6431 | |
| (910) 790-0187 | |
| (910) 790-0189 |
| Full Name | Coastal Horizons Center, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 615 Shipyard Blvd, Wilmington, North Carolina |
| Authorized Official Name and Position | Margaret Weller Stargell (PRESIDENT & CEO) |
| Authorized Official Contact | 9107900187 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Horizons Center, Inc. 615 Shipyard Blvd Wilmington NC 28412-6431 Ph: (910) 790-0187 | Coastal Horizons Center, Inc. 615 Shipyard Blvd Wilmington NC 28412-6431 Ph: (910) 790-0187 |
| NPI Number | 1922022607 |
|---|---|
| Provider Enumeration Date | 07/27/2006 |
| Last Update Date | 07/28/2014 |
| Medicare PECOS PAC ID | 9739267964 |
|---|---|
| Medicare Enrollment ID | O20080429000046 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922022607 | NPI | - | NPPES |
| 8300416B | Medicaid | NC | |
| 5900561 | Medicaid | NC | |
| 8300416 | Medicaid | NC | |
| 8301322G | Medicaid | NC | |
| 8300416Q | Medicaid | NC | |
| 8300416T | Medicaid | NC | |
| 6005343 | Medicaid | NC | |
| 8300416H | Medicaid | NC | |
| 8301322H | Medicaid | NC | |
| 8301322 | Medicaid | NC | |
| 8300416G | Medicaid | NC | |
| 8301322B | Medicaid | NC |
| Provider Name | Charles L Ewell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1710938535 PECOS PAC ID: 7315841954 Enrollment ID: I20040722000857 |
| Provider Name | Angela D Stanley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740347442 PECOS PAC ID: 2860431145 Enrollment ID: I20050426001276 |
| Provider Name | Sara Little Hubbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538166566 PECOS PAC ID: 0244251502 Enrollment ID: I20051214000446 |
| Provider Name | Robert Seigel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912043050 PECOS PAC ID: 9931295664 Enrollment ID: I20071011000093 |
| Provider Name | Bruce W Riggins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548329196 PECOS PAC ID: 2163592635 Enrollment ID: I20080610000632 |
| Provider Name | Elizabeth Uzcategui |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265675151 PECOS PAC ID: 1951549393 Enrollment ID: I20130524000406 |
| Provider Name | Robert M Licata |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669522769 PECOS PAC ID: 2567611494 Enrollment ID: I20151110000931 |
| Provider Name | Ana R Blaney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902049844 PECOS PAC ID: 9032408299 Enrollment ID: I20160512000017 |
| Provider Name | Michael C Odibo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144496191 PECOS PAC ID: 4981765104 Enrollment ID: I20160815000550 |
| Provider Name | Derek T Shelton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720492994 PECOS PAC ID: 0547556664 Enrollment ID: I20160915000859 |
| Provider Name | Matthew Hunter Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1922340512 PECOS PAC ID: 8921387317 Enrollment ID: I20161107001808 |
| Provider Name | Patrick Gregory Bruff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538608666 PECOS PAC ID: 5890070064 Enrollment ID: I20170330002117 |
| Provider Name | Danielle T Fryar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972954196 PECOS PAC ID: 4385911304 Enrollment ID: I20170523001997 |
| Provider Name | Naomi Flock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164840351 PECOS PAC ID: 5395962070 Enrollment ID: I20170828002366 |
| Provider Name | Naomi Flock |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164840351 PECOS PAC ID: 5395962070 Enrollment ID: I20170928003104 |
| Provider Name | Lucien S Wilkins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851539662 PECOS PAC ID: 0749556462 Enrollment ID: I20171025001617 |
| Provider Name | Susan Marie Brandt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801945837 PECOS PAC ID: 4880937846 Enrollment ID: I20190515002432 |
| Provider Name | Anka Roberto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386199560 PECOS PAC ID: 4284967860 Enrollment ID: I20190613001811 |
| Provider Name | Mary Petrina Goodwin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124415302 PECOS PAC ID: 1456684810 Enrollment ID: I20190618000671 |
| Provider Name | Kathleen Scott |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417410960 PECOS PAC ID: 9234465618 Enrollment ID: I20190723001624 |
| Provider Name | Sarah Katherine Jacobs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124481981 PECOS PAC ID: 8325370091 Enrollment ID: I20191030000002 |
| Provider Name | Judylyn Hobson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316578388 PECOS PAC ID: 5496185167 Enrollment ID: I20200420003254 |
| Provider Name | Lauren Turner Duffy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346874898 PECOS PAC ID: 5496185787 Enrollment ID: I20200429001800 |
| Provider Name | Alan Robert Brailsford De Lopez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235600057 PECOS PAC ID: 1052744539 Enrollment ID: I20200520002237 |
| Provider Name | Brooke Alyse Gibson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851871867 PECOS PAC ID: 2264859685 Enrollment ID: I20200901000049 |
| Provider Name | Darlene Carson Webb |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386748754 PECOS PAC ID: 4880013374 Enrollment ID: I20201002000485 |
| Provider Name | Heather Nichole Black |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447850458 PECOS PAC ID: 1355758087 Enrollment ID: I20210325001164 |
| Provider Name | Amanda Dawn Kazee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871007963 PECOS PAC ID: 4587072301 Enrollment ID: I20210415002641 |
| Provider Name | Marjorie Tartt Justice |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902462930 PECOS PAC ID: 2264836923 Enrollment ID: I20210803003259 |
| Provider Name | Sarah Katherine Burns |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023605789 PECOS PAC ID: 2769875665 Enrollment ID: I20220216001454 |
| Provider Name | Beth Tam Carson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356919823 PECOS PAC ID: 8820481765 Enrollment ID: I20220217000063 |
| Provider Name | Milan Karen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730849589 PECOS PAC ID: 5890180665 Enrollment ID: I20220314000276 |
| Provider Name | Heather Marie Rubino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114589504 PECOS PAC ID: 2860887585 Enrollment ID: I20220316001226 |
| Provider Name | Jacob Thomas Averill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659930618 PECOS PAC ID: 8820483233 Enrollment ID: I20220322002379 |
| Provider Name | Kelly House Long |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447408133 PECOS PAC ID: 6002292224 Enrollment ID: I20220926001567 |
| Provider Name | Maricruz Ramirez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124670237 PECOS PAC ID: 7911383856 Enrollment ID: I20220930000483 |
| Provider Name | Janice Aimee Padron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023675246 PECOS PAC ID: 4486030228 Enrollment ID: I20221003001840 |
| Provider Name | Joseph Edward Barry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417517889 PECOS PAC ID: 1052789237 Enrollment ID: I20221118001274 |
| Provider Name | Christian Gilbert |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1750348421 PECOS PAC ID: 2264336775 Enrollment ID: I20230117000841 |
| Provider Name | Allison Linsey Porter |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1124401419 PECOS PAC ID: 0042685687 Enrollment ID: I20230412001536 |
| Provider Name | Andrea Morgan Formyduval Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154550077 PECOS PAC ID: 4880057363 Enrollment ID: I20230831000540 |
| Provider Name | Christopher Dean Thorpe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093323594 PECOS PAC ID: 1658720867 Enrollment ID: I20231213003271 |
| Provider Name | Cara Lyne-ann Vitadamo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184306193 PECOS PAC ID: 6002266806 Enrollment ID: I20231220000010 |
| Provider Name | Charles Alan Barrett |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073543682 PECOS PAC ID: 9335590702 Enrollment ID: I20240110001772 |
| Provider Name | Glenda Debose |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437537768 PECOS PAC ID: 1557713682 Enrollment ID: I20240114000183 |
| Provider Name | Deborah Ann Silva |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1467714998 PECOS PAC ID: 9032562681 Enrollment ID: I20240130003057 |
| Provider Name | Brooke Lee Simpson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013518745 PECOS PAC ID: 1951744622 Enrollment ID: I20240209000853 |
| Provider Name | Fred Thomas Paul Shah |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1073857124 PECOS PAC ID: 4789027186 Enrollment ID: I20240213000119 |
| Provider Name | Jeremy B Seamon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1659673184 PECOS PAC ID: 2860836186 Enrollment ID: I20240214003723 |
| Provider Name | Lauren Madden Britton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750918496 PECOS PAC ID: 3577907831 Enrollment ID: I20240215000468 |
| Provider Name | Mary Caroline Neville |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437644291 PECOS PAC ID: 9739523093 Enrollment ID: I20240215000551 |
| Provider Name | Sara Lynn Jablonski |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1942545272 PECOS PAC ID: 0547606345 Enrollment ID: I20240315000713 |
| Provider Name | Britton Tyler Seivert |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295353381 PECOS PAC ID: 9931546652 Enrollment ID: I20240318001515 |
| Provider Name | Samantha Leigh Kiger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740786920 PECOS PAC ID: 2860839545 Enrollment ID: I20240318003359 |
| Provider Name | Karimah Lona Bradley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407301658 PECOS PAC ID: 7719324979 Enrollment ID: I20240322003041 |
| Provider Name | Amanda Joann Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225575269 PECOS PAC ID: 8628417425 Enrollment ID: I20240412001518 |
| Provider Name | Jeffrey Lee Simmons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508435744 PECOS PAC ID: 3072952506 Enrollment ID: I20240417002077 |
| Provider Name | Christopher John Mullen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376008839 PECOS PAC ID: 9436590395 Enrollment ID: I20240509003557 |
| Provider Name | Candace Marie Scirrotto |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376017616 PECOS PAC ID: 9436590296 Enrollment ID: I20240509004036 |
| Provider Name | Haley Kristina Meyer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104476530 PECOS PAC ID: 4688015183 Enrollment ID: I20240515002091 |
| Provider Name | Gayle Michele Beese |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629596937 PECOS PAC ID: 2860934460 Enrollment ID: I20240611002551 |
Mqa Support Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 233 Westchester Rd, Wilmington, NC 28409 Phone: 202-658-6337 | |
Coastal Horizons Center, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 615 Shipyard Blvd, Wilmington, NC 28412 Phone: 910-790-0187 Fax: 910-790-0189 | |
Pinnacle Family Services Of North Carolina Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1608 Queen St Ste 3, Wilmington, NC 28401 Phone: 919-790-8580 | |
Crystal River Psychiatric, Grp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2595 S 17th St, Wilmington, NC 28401 Phone: 910-799-2283 Fax: 910-791-9227 | |
Compass Rose Psychotherapy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 313 Walnut St Ste 108, Wilmington, NC 28401 Phone: 910-233-1878 | |
Cultivate Wellness Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3807 Wrightsville Ave Ste 24, Wilmington, NC 28403 Phone: 910-902-9293 Fax: 910-778-1156 | |
The Healing Point, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3205 Randall Pkwy Ste 128, Wilmington, NC 28403 Phone: 910-338-9093 |