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General NPI Number Information
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NPI Number | 1417861261
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Entity Type | Organization
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Legal Business Name | COASTAL BEHAVIOR CARE, LLC
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Dates
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Enumeration Date | 09/29/2026
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 35 8TH ST
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City | HERMOSA BEACH
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State | CA
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Zip | 90254-4101
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Country | US
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Telephone | 303-229-0815
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Fax |
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Provider Business Mailing Address
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Address Line | 703 PIER AVE STE B230
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City | HERMOSA BEACH
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State | CA
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Zip | 90254-3949
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Country | US
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Telephone | 303-229-0815
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MS. ERIN MARIE CONNELLY
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Credential | BCBA
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Telephone | 303-229-0815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State | NULL
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