| Coastal Support Specialists, Inc. | |
|
2460 Delaney Ave Wilmington NC 28403-6062 | |
| (910) 792-6130 | |
| (910) 792-6132 |
| Full Name | Coastal Support Specialists, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 2460 Delaney Ave, Wilmington, North Carolina |
| Authorized Official Name and Position | Camillus (case) P. Van Der Kuijl (FINANCIAL OFFICER) |
| Authorized Official Contact | 9102331374 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Support Specialists, Inc. 2460 Delaney Ave Wilmington NC 28403-6062 Ph: (910) 792-6130 | Coastal Support Specialists, Inc. 2460 Delaney Ave Wilmington NC 28403-6062 Ph: (910) 792-6130 |
| NPI Number | 1780869297 |
|---|---|
| Provider Enumeration Date | 01/03/2008 |
| Last Update Date | 08/16/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780869297 | NPI | - | NPPES |
| 6008286 | Medicaid | NC | |
| 8702029 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
| 103T00000X | Psychologist | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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