Organization
COASTAL PSYCHIATRIC CENTER, INC.
Active
Other names
Coastal Psychiatric Urgent Care, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA KARLE PH.D. (EXECUTIVE DIRECTOR)
(321) 586-5444
Entity
Organization
Contact information
Practice address
1335 VALENTINE ST, MELBOURNE, FL 32901-3127
(321) 586-5444
(321) 319-9712
Mailing address
1335 VALENTINE ST, MELBOURNE, FL 32901-3127
(321) 586-5444
(321) 319-9712
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
2084P0800X
Psychiatry Physician
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109565100
—
FL
Enumeration date
05/21/2019
Last updated
05/26/2022
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