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Organization
COASTAL GREEN HEALING, PLLC
Active
Organization
COASTAL GREEN HEALING, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MEGAN MARY KELLY GILMAN MSN, APRN, PMHNP-BC (OWNER)
(203) 641-2530
Entity
Organization
Contact information
Practice address
30 OLD KINGS HIGHWAY SOUTH, 1ST FLOOR STE 202, DARIEN, CT 06820-4551
(877) 692-6772
(204) 904-2446
Mailing address
1204 MAIN ST # 925, BRANFORD, CT 06405-3787
(203) 444-3076
(203) 904-2446
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
312631
ATN
CT
Enumeration date
03/12/2021
Last updated
03/12/2021
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