Organization
COASTAL COUNSELING AND SUPERVISION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA DIXON LISW-CP (OWNER)
(443) 414-5910
Entity
Organization
Contact information
Practice address
884 ALLBRITTON BLVD STE 110, MOUNT PLEASANT, SC 29464-3092
(434) 414-5910
Mailing address
1552 STRATHENE CT, MOUNT PLEASANT, SC 29466-9384
(443) 414-5910
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/26/2025
Last updated
05/06/2025
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