Provider Demographics
NPI:1265901961
Name:COASTAL COUNSELING INC
Entity type:Organization
Organization Name:COASTAL COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:D
Authorized Official - Last Name:SIELAND
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:978-810-5375
Mailing Address - Street 1:9 DANE ST STE 2B
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-4514
Mailing Address - Country:US
Mailing Address - Phone:978-810-5375
Mailing Address - Fax:978-238-1840
Practice Address - Street 1:9 DANE ST STE 2B
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-4514
Practice Address - Country:US
Practice Address - Phone:978-810-5375
Practice Address - Fax:978-238-1840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty