Coastal Concierge Counseling, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

COASTAL CONCIERGE COUNSELING, LLC

Practice address

1 Marsh Haven LN
Savannah, GA 31411-2718

Phone

(404) 304-4784

NPI assigned

Aug 2, 2021

Last updated

Aug 4, 2021By 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

Kimela M Boone, LCSWNPI 1588156418

Title

Owner

Phone

(404) 304-4784

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, SC, FL3 enrollments

Enrollment records 3

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.

• Kimela Boone, LCSW

  • Clinical Social Worker
  • Savannah, FL
  • NPI 1588156418

  GA, SC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1627862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628035200000",
    "number": "1750055067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MARSH HAVEN LN",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314112718",
            "telephone_number": "404-304-4784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MARSH HAVEN LN",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314112718",
            "telephone_number": "404-304-4784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL CONCIERGE COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-02",
        "last_updated": "2021-08-04",
        "certification_date": "2021-08-04",
        "status": "A",
        "authorized_official_last_name": "BOONE",
        "authorized_official_first_name": "KIMELA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-304-4784",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Savannah, GA
• Providers in Savannah, GA by specialty
• Community/Behavioral Health Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2021; 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.