Coastal Psychological Group, LLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

COASTAL PSYCHOLOGICAL GROUP, LLC

Practice address

3005 Lithia Pinecrest Rd
Valrico, FL 33596-5630

Phone

(516) 315-9771

NPI assigned

Nov 18, 2020

Last updated

Nov 18, 2020By 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

Amanda Bauer-Manzella, LMHC

Title

Owner

Phone

(516) 315-9771

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 3

Interoperability endpoints

• Direct secure messaging: office@coastalpsychologicalgroupfl.com

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amanda Michele Bauer, LMHC

  • Mental Health Counselor
  • Valrico, FL
  • NPI 1437752953
  NPD

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

{
    "created_epoch": "1605657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1487257853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3005 LITHIA PINECREST RD",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335965630",
            "telephone_number": "516-315-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 LITHIA PINECREST RD",
            "city": "VALRICO",
            "state": "FL",
            "postal_code": "335965630",
            "telephone_number": "516-315-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL PSYCHOLOGICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-18",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "BAUER-MANZELLA",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-315-9771",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1437752953",
            "identifier": "1437752953",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@coastalpsychologicalgroupfl.com",
            "affiliation": "N",
            "address_1": "3005 Lithia Pinecrest Rd",
            "city": "Valrico",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335965630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@coastalpsychologicalgroupfl.com",
            "affiliation": "N",
            "address_1": "3005 Lithia Pinecrest Rd",
            "city": "Valrico",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335965630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "office@coastalpsychologicalgroupfl.com",
            "affiliation": "N",
            "address_1": "3005 Lithia Pinecrest Rd",
            "city": "Valrico",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335965630",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Megan S Cochran, ATC
• Gillena Cohen

• Mental Health Counselor in Valrico, FL
• Providers in Valrico, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.