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General NPI Number Information
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NPI Number | 1932884046
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Entity Type | Organization
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Legal Business Name | COASTAL CAROLINA BEHAVIORAL HEALTH, INC.
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Dates
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Enumeration Date | 06/16/2023
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Last Update Date | 10/28/2025
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Provider Practice Location Address
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Address Line | 2734 BEAVER RUN BLVD UNIT D
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City | SURFSIDE BEACH
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State | SC
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Zip | 29575-5392
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Country | US
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Telephone | 843-650-1085
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Fax | 843-650-1088
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Provider Business Mailing Address
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Address Line | 2734 BEAVER RUN BLVD UNIT D
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City | SURFSIDE BEACH
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State | SC
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Zip | 29575-5392
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Country | US
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Telephone | 843-650-1085
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Fax | 843-650-1088
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Authorized Official
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Title or Position | CO-OWNER/VP
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Name | SAMANTHA GIERMANN
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Credential |
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Telephone | 843-650-1085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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