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General NPI Number Information
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NPI Number | 1891420402
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Entity Type | Organization
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Legal Business Name | COASTAL MINDS COUNSELING CENTER
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Dates
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Enumeration Date | 07/18/2022
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Last Update Date | 09/07/2023
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Provider Practice Location Address
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Address Line | 3 CORPORATE PLAZA DR STE 102
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-7954
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Country | US
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Telephone | 949-919-0428
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Fax |
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Provider Business Mailing Address
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Address Line | 3 CORPORATE PLAZA DR STE 102
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City | NEWPORT BEACH
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State | CA
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Zip | 92660-7954
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Country | US
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Telephone | 949-919-0428
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Fax | 949-209-0332
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Authorized Official
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Title or Position | FOUNDER
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Name | KARI SYLVESTER
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Credential | LCSW, MED
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Telephone | 858-735-6213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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