| Coastal Psychiatry, Llc | |
|
1030 Jenkins Rd Suite A Charleston SC 29407-5704 | |
| (843) 852-0083 | |
| (843) 852-0087 |
| Full Name | Coastal Psychiatry, Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1030 Jenkins Rd, Charleston, South Carolina |
| Authorized Official Name and Position | Sandra H Matthews (BILLING REPRESENTATIVE) |
| Authorized Official Contact | 8435328549 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Psychiatry, Llc 1030 Jenkins Rd Suite A Charleston SC 29407-5704 Ph: (843) 852-0083 | Coastal Psychiatry, Llc 1030 Jenkins Rd Suite A Charleston SC 29407-5704 Ph: (843) 852-0083 |
| NPI Number | 1699702654 |
|---|---|
| Provider Enumeration Date | 06/27/2006 |
| Last Update Date | 11/30/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699702654 | NPI | - | NPPES |
| GP3354 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
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