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General NPI Number Information
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NPI Number | 1962307918
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Entity Type | Organization
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Legal Business Name | COASTAL STREAM COUNSELING
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Dates
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Enumeration Date | 10/09/2026
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Last Update Date | 10/09/2026
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Provider Practice Location Address
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Address Line | 168 GRAYSON AVE
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City | SAVANNAH
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State | GA
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Zip | 31419-8147
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Country | US
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Telephone | 478-484-6991
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Fax |
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Provider Business Mailing Address
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Address Line | 168 GRAYSON AVE
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City | SAVANNAH
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State | GA
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Zip | 31419-8147
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Country | US
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Telephone | 478-484-6991
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | EARNESTINE HILSON RAINEY
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Credential | LPC, LMHC, NCC
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Telephone | 478-484-6991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | NULL
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