NPIMap

Organization Active NPI

Coastal Haven Counseling LLC

  • Mental Health Counselor
  • Myrtle Beach, SC
National Provider Identifier
1609314293
Registry record updated Oct 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
COASTAL HAVEN COUNSELING LLC
Practice address
220 Ronnie CT Ste 2
Myrtle Beach, SC 29579-4192
Phone
(843) 945-0346
Fax
(843) 432-3091
NPI assigned
Feb 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2019

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

Authorized official

Name
Sandra Elaine QuastNPI 1174936702
Title
LPC
Phone
(843) 945-0346

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary
Community/Behavioral Health Agency 251S00000X 6522 SC

Addresses

Primary practice location

220 Ronnie CT Ste 2
Myrtle Beach, SC 29579-4192

Mailing address

220 Ronnie CT Ste 2
Myrtle Beach, SC 29579-4192
Phone (843) 945-0346

Other practice location 1

3100 Dick Pond Rd Ste D2
Myrtle Beach, SC 29588-7286
Phone (843) 945-0346

Other practice location 2

215 Ronnie Ct Ste D1
Myrtle Beach, SC 29579-4204
Phone (201) 669-0055

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200127001494 SC Part B Supplier - Clinic/Group Practice 2365877008 Receives reassigned benefits from 3 practitioners
Practice locations: Myrtle Beach, SC

National Provider Directory

National Provider Directory

Locations

3100 Dick Pond Rd
Ste D2
Myrtle Beach, SC 29588
Phone (843) 945-0346

215 Ronnie Ct
Ste D1
Myrtle Beach, SC 29579
Phone (201) 669-0055

220 Ronnie Ct
Ste 2
Myrtle Beach, SC 29579
Phone (843) 902-9274

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1486080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571961600000",
    "number": "1609314293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 RONNIE CT STE 2",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794192",
            "telephone_number": "843-945-0346",
            "fax_number": "843-432-3091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 RONNIE CT STE 2",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295794192",
            "telephone_number": "843-945-0346",
            "fax_number": "843-432-3091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 Dick Pond Rd Ste D2",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295887286",
            "country_code": "US",
            "telephone_number": "843-945-0346",
            "fax_number": "843-432-3091",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "215 Ronnie Ct Ste D1",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295794204",
            "country_code": "US",
            "telephone_number": "201-669-0055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COASTAL HAVEN COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-03",
        "last_updated": "2019-10-25",
        "status": "A",
        "authorized_official_last_name": "QUAST",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "LPC",
        "authorized_official_telephone_number": "843-945-0346"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "SC",
            "license": "6522",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.