Organization
COASTAL COUNSELING ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD CHARLES CAMPBELL PH.D. (PARTNER)
(910) 350-0004
Entity
Organization
Contact information
Practice address
115 HINTON AVE, SUITE 7, WILMINGTON, NC 28403-4785
(910) 350-0004
(910) 350-1206
Mailing address
115 HINTON AVE, SUITE 7, WILMINGTON, NC 28403-4785
(910) 350-0004
(910) 350-1206
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1680
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6000486
—
NC
Enumeration date
09/24/2007
Last updated
01/25/2012
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