Coastal Neuropsychology Services, P.a.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

1449 Issued in SC

Legal business name

COASTAL NEUROPSYCHOLOGY SERVICES, P.A.

Practice address

1608 Paradise Lake Dr
Mount Pleasant, SC 29464-5719

Phone

(860) 997-4723

Fax

(860) 997-4723

NPI assigned

May 22, 2017

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Jesse Daniel Chasman, PH.D.NPI 1366724361

Title

Director

Phone

(860) 997-4723

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jesse Daniel Chasman, PH.D.

  • Clinical Neuropsychologist
  • Mount Pleasant, SC
  • NPI 1366724361
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495411200000",
    "number": "1093242091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2520",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294652520",
            "telephone_number": "860-997-4723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 PARADISE LAKE DR",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294645719",
            "telephone_number": "860-997-4723",
            "fax_number": "860-997-4723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL NEUROPSYCHOLOGY SERVICES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-22",
        "last_updated": "2017-05-22",
        "status": "A",
        "authorized_official_last_name": "CHASMAN",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "860-997-4723",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "SC",
            "license": "1449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coastal Counseling and Supervision, LLC
• Coastal Dermatology, LLC
• Coastal Early Intervention LLC
• Coastal Family Dentistry
• Coastal Fertility Center
• Coastal Pediatric Associates, PA
• Coastal Podiatry LLC
• Coastal Podiatry, LLC
• Coastal Podiatry, LLC
• Coastal Spine & Wellness Family Chiropractic

• Clinical Neuropsychologist in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Clinical Neuropsychologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.