Organization
COASTAL COMMUNITY COUNSELING SERVICES LLC
Active
Organization
COASTAL COMMUNITY COUNSELING SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE ILLMENSEE LCSW (OWNER/DIRECTOR)
(732) 610-8396
Entity
Organization
Contact information
Practice address
268 PELICAN RD, MIDDLETOWN, NJ 07748-3040
(732) 610-8396
Mailing address
268 PELICAN RD, MIDDLETOWN, NJ 07748-3040
(732) 610-8396
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05738600
NJ
Other
Enumeration date
12/29/2017
Last updated
10/16/2025
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