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General NPI Number Information
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NPI Number | 1053294116
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Entity Type | Organization
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Legal Business Name | COASTAL COUNSELING AND ART THERAPY LLC
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 14 MAINE ST SUITE 202
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City | BRUNWICK
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State | ME
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Zip | 04011
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Country | US
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Telephone | 207-332-8567
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Fax |
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Provider Business Mailing Address
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Address Line | 14 MAINE ST SUITE 202 BOX 61
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City | BRUNSWICK
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State | ME
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Zip | 04011
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Country | US
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Telephone | 207-332-8567
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Fax |
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Authorized Official
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Title or Position | OWNER/COUNSELOR
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Name | ASHLEY C COULON
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Credential |
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Telephone | 207-332-8567
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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