Coastal Innovative Counseling Solutions, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW003068 Issued in GA

Legal business name

COASTAL INNOVATIVE COUNSELING SOLUTIONS, LLC

Practice address

1 Johnston St
Suite 6
Savannah, GA 31405-5531

Phone

(912) 495-5600

Fax

(855) 223-9969

NPI assigned

Mar 27, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Helen D Schandolph, LCSW

Title

Ceo

Phone

(912) 713-6275

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Helen Schandolph Former legal business name

Locations

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490572800000",
    "number": "1124559471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13309",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314160309",
            "telephone_number": "912-495-5600",
            "fax_number": "855-223-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JOHNSTON ST",
            "address_2": "SUITE 6",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314055531",
            "telephone_number": "912-495-5600",
            "fax_number": "855-223-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL INNOVATIVE COUNSELING SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-27",
        "last_updated": "2017-03-27",
        "status": "A",
        "authorized_official_last_name": "SCHANDOLPH",
        "authorized_official_first_name": "HELEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-713-6275",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW003068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORAL HEALTH",
            "identifier": "465197000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL SOCIAL WORKER",
            "identifier": "CSW003068",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Helen Schandolph",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Clinical Social Worker in Savannah, GA
• Providers in Savannah, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2017; 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.