# COASTAL COUNSELING CENTER OF TIDEWATER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Stacia Chapman-Gorey
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992208367
- **Authorized official:** STACIA CHAPMAN-GOREY LCSW (LCSW)
- **Authorized official phone:** (757) 345-6428

## Contact information

- **Practice address:** 215 MCLAWS CIR STE 1, WILLIAMSBURG, VA 23185-5799
- **Practice address phone:** (757) 345-6428
- **Practice address fax:** (757) 345-6808
- **Mailing address:** 215 MCLAWS CIR STE 1, WILLIAMSBURG, VA 23185-5799
- **Mailing address phone:** (757) 345-6428
- **Mailing address fax:** (757) 345-6808

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 104100000X | Social Worker | 0904009449 | VA | Yes |

## Other

- **Enumeration date:** 03/13/2018
- **Last updated:** 03/13/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1194862813 | INDIVIDUAL NPI | VA |