| Coastal Neuropsychology Services, P.a. | |
|
1608 Paradise Lake Dr Mount Pleasant SC 29464-5719 | |
| (860) 997-4723 | |
| (860) 997-4723 |
| Full Name | Coastal Neuropsychology Services, P.a. |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 1608 Paradise Lake Dr, Mount Pleasant, South Carolina |
| Authorized Official Name and Position | Jesse Daniel Chasman (DIRECTOR) |
| Authorized Official Contact | 8609974723 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Neuropsychology Services, P.a. Po Box 2520 Mount Pleasant SC 29465-2520 Ph: (860) 997-4723 | Coastal Neuropsychology Services, P.a. 1608 Paradise Lake Dr Mount Pleasant SC 29464-5719 Ph: (860) 997-4723 |
| NPI Number | 1093242091 |
|---|---|
| Provider Enumeration Date | 05/22/2017 |
| Last Update Date | 05/22/2017 |
| Medicare PECOS PAC ID | 3779857933 |
|---|---|
| Medicare Enrollment ID | O20170927000657 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093242091 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | 1449 (South Carolina) | Primary |
| Provider Name | Jesse Chasman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1366724361 PECOS PAC ID: 6406020585 Enrollment ID: I20170927000765 |
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