Organization
COASTAL PSYCHIATRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA H MATTHEWS (BILLING REPRESENTATIVE)
(843) 532-8549
Entity
Organization
Contact information
Practice address
1030 JENKINS RD, SUITE A, CHARLESTON, SC 29407-5704
(843) 852-0083
(843) 852-0087
Mailing address
1030 JENKINS RD, SUITE A, CHARLESTON, SC 29407-5704
(843) 852-0083
(843) 852-0087
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3354
—
SC
Enumeration date
06/27/2006
Last updated
11/30/2007
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