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General NPI Number Information
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NPI Number | 1902741713
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Entity Type | Organization
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Legal Business Name | COASTAL COUNSELING OF NORTH FLORIDA, LLC
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 4400 MARSH LANDING BLVD STE 104&203
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City | PONTE VEDRA
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State | FL
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Zip | 32082-7215
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Country | US
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Telephone | 904-373-1837
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Fax | 904-604-8700
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Provider Business Mailing Address
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Address Line | 3948 3RD ST S # 351
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City | JACKSONVILLE BEACH
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State | FL
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Zip | 32250-5847
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Country | US
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Telephone | 904-373-1837
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Fax | 904-604-8700
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Authorized Official
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Title or Position | OWNER
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Name | PAULA BAUER
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Credential | LCSW
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Telephone | 904-373-1837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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