# COASTAL PSYCHIATRY AND WELLNESS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Coastal Psychiatry and Wellness
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740089416
- **Authorized official:** TIMOTHY DERRICK SMITH (CEO AND PRACTICE MANAGER)
- **Authorized official phone:** (804) 923-4002

## Contact information

- **Practice address:** 10469 ATLEE STATION RD STE 100, ASHLAND, VA 23005-8913
- **Practice address phone:** (804) 923-4002
- **Mailing address:** 10469 ATLEE STATION RD STE 100, ASHLAND, VA 23005-8913
- **Mailing address phone:** (804) 932-4002
- **Mailing address fax:** (833) 974-3888

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 03/13/2025
- **Last updated:** 12/29/2025