Healthcare Provider Details

I. General information

NPI: 1578426086
Provider Name (Legal Business Name): COASTAL CALM COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9821 SC 905 SUITE A
LONGS SC
29568
US

IV. Provider business mailing address

422 ASHBY ST # A
MYRTLE BEACH SC
29579-9105
US

V. Phone/Fax

Practice location:
  • Phone: 970-390-6969
  • Fax:
Mailing address:
  • Phone: 970-390-6969
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: LINDSEY D KING
Title or Position: OWNER/PROVIDER
Credential: LPC, LIMHP, LADC
Phone: 970-390-6969