Coastal Counseling PCB, LLC

Primary specialty

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

License

11097 Issued in FL

Legal business name

COASTAL COUNSELING PCB, LLC

Doing business as

Coastal Counseling PCB

Practice address

400 Thomas Dr.
7108
Panama City Beach, FL 32408

Phone

(850) 733-7720

NPI assigned

Apr 23, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Tregon Fitch, LMHCNPI 1457851560

Title

Manager/Counselor

Phone

(850) 733-7720

Specialties & licenses 1

Addresses

Other names 1

• Coastal Counseling PCB Doing business as

Practitioners 1

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

• Tregon Fitch, EDD, LMHC

  • Mental Health Counselor
  • Panama City Beach, FL
  • NPI 1457851560
  NPD (past) Authorized official

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524441600000",
    "number": "1730676057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2522 PELICAN BAY DR",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324087046",
            "telephone_number": "850-733-7720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 THOMAS DR.",
            "address_2": "7108",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "32408",
            "telephone_number": "850-733-7720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL COUNSELING PCB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-23",
        "last_updated": "2018-04-23",
        "status": "A",
        "authorized_official_last_name": "FITCH",
        "authorized_official_first_name": "TREGON",
        "authorized_official_title_or_position": "MANAGER/COUNSELOR",
        "authorized_official_telephone_number": "850-733-7720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "FL",
            "license": "11097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Counseling PCB",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Coastal Counseling PCB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• CHP Panama City FL Tenant Corp.
• Jennifer Lynn Christensen, MPT
• Jessica Lynn Clark, MD
• Suzanne Clark, LCSW
• Payson Elizabeth Clifford
• Coastal Family Practice & Acute Care Center LLC
• Coastal Internal Medicine, LLC
• Coastal Tides Surgical Center, LLC
• Jennifer Lynne Coleman, FNP
• Carol J. Collins, RPH

• Mental Health Clinic/Center (Including Community Mental Health Center) in Panama City Beach, FL
• Providers in Panama City Beach, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2018; 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.