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General NPI Number Information
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NPI Number | 1841106994
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Entity Type | Organization
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Legal Business Name | COASTAL MIND & WELLNESS GROUP PLLC
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Dates
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Enumeration Date | 08/19/2026
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Last Update Date | 08/19/2026
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Provider Practice Location Address
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Address Line | 41 KINGS HWY STE 203
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City | GALES FERRY
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State | CT
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Zip | 06335-1543
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Country | US
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Telephone | 860-389-4381
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Fax |
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Provider Business Mailing Address
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Address Line | 41 KINGS HWY STE 203
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City | GALES FERRY
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State | CT
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Zip | 06335-1543
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Country | US
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Telephone | 860-389-4381
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Fax |
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Authorized Official
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Title or Position | APRN/OWNER
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Name | RENEE LACADIE
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Credential | APRN
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Telephone | 860-389-4381
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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