MEDICARE: COASTAL MENTAL HEALTH CENTER INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1861149734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COASTAL MENTAL HEALTH CENTER INC

Provider Business Mailing Address
First Line	:	665 W WARREN AVE
Second Line	:
City	:	LONGWOOD
State	:	FL
Zip	:	32750-4004
Country	:	US
Telephone Number	:	800-614-4124
Fax Number	:	888-217-4124

Provider Business Practice Location Address
First Line	:	2475 PALM BAY RD NE STE 225
Second Line	:
City	:	PALM BAY
State	:	FL
Zip	:	32905-3339
Country	:	US
Telephone Number	:	800-614-4124
Fax Number	:	888-217-4124

Authorized Official
Title or Position	:	DIRECTOR
Name	:	TAMAR RICHARDSON
Credential	:
Telephone Number	:	407-347-6387

Provider Enumeration Date	:	03/09/2022
Last Update Date	:	10/25/2023

Similar Medicare Providers

1992138234 — CSI NURSE WORLD, INC.
Practice Location Address:

2475 PALM BAY RD NE STE 215
PALM BAY, FL
32905-3339

Practice Phone: 321-722-0009
Practice Fax: 321-722-0520

1306791934 — KATHY7 CARROLL
Practice Location Address:

3339 SW CORNELL AVE
PALM CITY, FL
34990-3427

Practice Phone: 772-214-5000
Practice Fax: 772-214-5000

1679420129 — TATIANA SMITH RBT
Practice Location Address:

2475 PALM BAY RD NE STE 231
PALM BAY, FL
32905-3359

Practice Phone: 321-914-4055
Practice Fax: 321-473-8829

1225983737 — ALEXIS SKYE DEAB
Practice Location Address:

2125 PALM PLACE DR NE
PALM BAY, FL
32905-3961

Practice Phone: 321-557-6293
Practice Fax: 321-557-6293

1437843745 — ALL PARTNERS NETWORK LLC
Practice Location Address:

1051 PORT MALABAR BLVD NE STE 6-7
PALM BAY, FL
32905-5153

Practice Phone: 800-735-1178
Practice Fax: 772-223-6354

1225869845 — LYDIANA VENEGA MARTINEZ MS, LMHC
Practice Location Address:

1211 DANIA CIR NE
PALM BAY, FL
32905-6352

Practice Phone: 321-241-9892
Practice Fax:

Directions to “COASTAL MENTAL HEALTH CENTER INC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.