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Organization
COASTAL PSYCHIATRIC CENTER, INC.
Active
Organization
COASTAL PSYCHIATRIC CENTER, INC.
Active
Other names
Coastal Psychiatric Urgent Care, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA KARLE PH.D. (EXECUTIVE DIRECTOR)
(321) 586-5444
Entity
Organization
Contact information
Practice address
1335 VALENTINE ST, MELBOURNE, FL 32901-3127
(321) 586-5444
(321) 319-9712
Mailing address
1335 VALENTINE ST, MELBOURNE, FL 32901-3127
(321) 586-5444
(321) 319-9712
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
2084P0800X
Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109565100
—
FL
Enumeration date
05/21/2019
Last updated
05/26/2022
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