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Organization

COASTAL CAROLINA PROFESSIONAL COUNSELING SERVICES, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
STEPHEN SCOTT RADOSEVICH LCMHC (OWNER)
(252) 777-2016
Entity
Organization

Contact information

Practice address
209 N 35TH ST STE B3, MOREHEAD CITY, NC 28557-3183
(252) 777-2016
(252) 656-2624
Mailing address
PO BOX 460, NEWPORT, NC 28570-0460

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
251S00000X
Community/Behavioral Health Agency
Primary
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
261QM0850X
Adult Mental Health Clinic/Center
261QM0855X
Adolescent and Children Mental Health Clinic/Center

Other

Enumeration date
12/07/2021
Last updated
11/30/2022
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