NPIMap

Organization Active NPI

Coastal Mental Health Center Inc

  • Community/Behavioral Health Agency
  • Saint Cloud, FL
National Provider Identifier
1114674082
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
COASTAL MENTAL HEALTH CENTER INC
Practice address
2900 17TH St Ste 3
Saint Cloud, FL 34769-6098
Phone
(800) 614-4124
Fax
(888) 217-4124
NPI assigned
Mar 9, 2022
Last updated
Jan 11, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Authorized official

Name
Tamar Richardson
Title
Director
Phone
(407) 347-6387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2900 17TH St Ste 3
Saint Cloud, FL 34769-6098

Mailing address

665 W Warren Ave
Longwood, FL 32750-4004
Phone (800) 614-4124

Other identifiers 1

IdentifierTypeStateIssuer
000959605MedicaidFL

National Provider Directory

National Provider Directory
Tax ID family
Coastal Mental Health Center Inc10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1646784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1114674082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 W WARREN AVE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504004",
            "telephone_number": "800-614-4124",
            "fax_number": "888-217-4124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 17TH ST STE 3",
            "city": "SAINT CLOUD",
            "state": "FL",
            "postal_code": "347696098",
            "telephone_number": "800-614-4124",
            "fax_number": "888-217-4124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL MENTAL HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-09",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "TAMAR",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "407-347-6387"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000959605",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Cloud, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.