Coastal Intensive Services

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

COASTAL INTENSIVE SERVICES

Practice address

3880 SE 8TH Ave
Portland, OR 97202-3772

Phone

(503) 789-6850

NPI assigned

Jul 19, 2024

Last updated

Jul 19, 2024By 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

Sarah Von ColditzNPI 1104224393

Title

Owner

Phone

(503) 789-6850

Specialties & licenses 4

Addresses

Other identifiers 2

Locations

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.

• Sarah Von Colditz, LCSW

  • Mental Health Counselor
  • Astoria, OR
  • NPI 1104224393
  NPD Authorized official

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

{
    "created_epoch": "1721347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721347200000",
    "number": "1689412850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 N HIGHWAY 101",
            "city": "WARRENTON",
            "state": "OR",
            "postal_code": "971469313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 SE 8TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023772",
            "telephone_number": "503-789-6850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL INTENSIVE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-19",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A",
        "authorized_official_last_name": "VON COLDITZ",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-789-6850"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104224393",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER",
            "identifier": "1770810723",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tanah Elisabeth Clunies-Ross, CNM
• Katelyn Cnossen, M.A., CCC-SLP
• Jasmine Co
• Skyler Erica Coady
• Fergus Coakley, MD
• Amy Elizabeth Coates, MBBS
• Justin Coates, CADC
• Lindsey Hale Coates, LPC
• Sarah Coates, MD
• Vania Coates

• Addiction (Substance Use Disorder) Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.