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Organization

COASTAL COUNSELING CENTER OF BRICK, LLC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOANN DEVIZIO (LMFT)
(732) 785-2744
Entity
Organization

Contact information

Practice address
1451 ROUTE 88 W, SUITE 4A, BRICK, NJ 08724-2371
(732) 785-2744
Mailing address
1451 ROUTE 88 W, SUITE 4A, BRICK, NJ 08724-2371
(732) 785-2744

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
SC 08766
NJ
1041C0700X
Clinical Social Worker
SC 45388
NJ
106H00000X
Marriage & Family Therapist
Primary
FI 001466
NJ

Other

Enumeration date
10/21/2010
Last updated
10/21/2010
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