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Organization
COASTAL CHRISTIAN COUNSELING
Active
Organization
COASTAL CHRISTIAN COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARLENA JANETTE PIQUE LCSW (OWNER/THERAPIST)
(681) 242-7651
Entity
Organization
Contact information
Practice address
112 BUENA VISTA DR, LONG BEACH, MS 39560-5703
(681) 242-7651
Mailing address
37 VANE DR, MARTINSBURG, WV 25403-0200
(681) 242-7651
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
NULL
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C9986
CLINICAL SOCIAL WORK LICENSE
MS
Enumeration date
09/17/2021
Last updated
09/17/2021
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