Gold Coast Consulting LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

GOLD COAST CONSULTING LLC

Doing business as

Gold Coast Consulting LLC
Phoenix Rising

Practice address

101 Devant St Ste 503
Fayetteville, GA 30214-2720

Phone

(770) 282-6962

Fax

(770) 282-6962

NPI assigned

Jun 13, 2022

Last updated

Jun 13, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Corey T Price

Title

Owner

Phone

(678) 709-9021

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Gold Coast Consulting LLC Doing business as
• Phoenix Rising Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1427788561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DEVANT ST STE 503",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142720",
            "telephone_number": "770-282-6962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DEVANT ST STE 503",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142720",
            "telephone_number": "770-282-6962",
            "fax_number": "770-282-6962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD COAST CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "PRICE",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-709-9021",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOT APPLICABLE",
            "identifier": "00000000000000000000",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "EHR",
            "affiliation": "N",
            "endpointDescription": "Electronic medical record",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "101 Devant St Ste 503",
            "city": "Fayetteville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302142720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Gold Coast Consulting LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Phoenix Rising",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rahul Kant Goel, MD
• Kevin Tyler Goelz, M.D.
• Ariana Goemaere
• Felicia Colton Goggins, NP
• Maurice Lamont Goins, MD
• Viviana Ines Goldenberg, M.D
• Gerald Alan Goldklang, M.D.
• Krishna J Goli, M.D.
• Kimberly Gomez, RBT
• Good Samartians Community Development Group, Inc.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.