Coastal Adolescent Behavioral Health

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

31462 Issued in SC

Legal business name

COASTAL ADOLESCENT BEHAVIORAL HEALTH

Practice address

1135 Bowman Rd Ste 529C
Mount Pleasant, SC 29464-3205

Phone

(843) 849-9009

NPI assigned

Jul 29, 2009

Organization subpart

No

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

Authorized official

Name

Katherine Graber Lazarovici

Title

President

Phone

(843) 849-9009

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1248825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278892800000",
    "number": "1184855876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1135 BOWMAN RD STE 529C",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643205",
            "telephone_number": "843-849-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1135 BOWMAN RD STE 529C",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "294643205",
            "telephone_number": "843-849-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL ADOLESCENT BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-29",
        "last_updated": "2010-07-12",
        "status": "A",
        "authorized_official_last_name": "GRABER LAZAROVICI",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-849-9009"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "SC",
            "license": "31462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adolescent and Children Mental Health Clinic/Center in Mount Pleasant, SC
• Providers in Mount Pleasant, SC by specialty
• Adolescent and Children Mental Health Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; 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.