| Coastal Psychological Group, Llc | |
|
3005 Lithia Pinecrest Rd Valrico FL 33596-5630 | |
| (516) 315-9771 | |
| Not Available |
| Full Name | Coastal Psychological Group, Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 3005 Lithia Pinecrest Rd, Valrico, Florida |
| Authorized Official Name and Position | Amanda Bauer-manzella (OWNER) |
| Authorized Official Contact | 5163159771 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Psychological Group, Llc 3005 Lithia Pinecrest Rd Valrico FL 33596-5630 Ph: (516) 315-9771 | Coastal Psychological Group, Llc 3005 Lithia Pinecrest Rd Valrico FL 33596-5630 Ph: (516) 315-9771 |
| NPI Number | 1487257853 |
|---|---|
| Provider Enumeration Date | 11/18/2020 |
| Last Update Date | 11/18/2020 |
| Certification Date | 11/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487257853 | NPI | - | NPPES |
| 1437752953 | Other | FL | 1437752953 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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