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Organization
COASTAL COUNSELING CENTER OF BRICK, LLC.
Active
Organization
COASTAL COUNSELING CENTER OF BRICK, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOANN DEVIZIO (LMFT)
(732) 785-2744
Entity
Organization
Contact information
Practice address
1451 ROUTE 88 W, SUITE 4A, BRICK, NJ 08724-2371
(732) 785-2744
Mailing address
1451 ROUTE 88 W, SUITE 4A, BRICK, NJ 08724-2371
(732) 785-2744
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
SC 08766
NJ
1041C0700X
Clinical Social Worker
SC 45388
NJ
106H00000X
Marriage & Family Therapist
Primary
FI 001466
NJ
Other
Enumeration date
10/21/2010
Last updated
10/21/2010
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