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General NPI Number Information
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NPI Number | 1912858473
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Entity Type | Organization
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Legal Business Name | COASTAL BEHAVIORAL HEALTH GROUP LLC
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Dates
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Enumeration Date | 02/09/2026
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 14700 TAMIAMI TRL N STE 1
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City | NAPLES
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State | FL
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Zip | 34110-6221
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Country | US
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Telephone | 239-212-0024
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Fax | 239-212-0024
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Provider Business Mailing Address
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Address Line | 14700 TAMIAMI TRL N STE 1
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City | NAPLES
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State | FL
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Zip | 34110-6221
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Country | US
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Telephone | 239-212-0024
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Fax | 239-212-0024
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | JERUSIA BROWN-ABREGO
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Credential | M.S., BCBA
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Telephone | 239-212-0024
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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 |
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