Coastal Community Counseling Services LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05738600 Issued in NJ

Legal business name

COASTAL COMMUNITY COUNSELING SERVICES LLC

Practice address

268 Pelican Rd
Middletown, NJ 07748-3040

Phone

(732) 610-8396

NPI assigned

Dec 29, 2017

Last updated

Oct 16, 2025By 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

Kellie Illmensee, LCSWNPI 1629592993

Title

Owner/Director

Phone

(732) 610-8396

Specialties & licenses 1

Addresses

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.

• Kellie Illmensee, LCSW

  • Clinical Social Worker
  • Middletown, NJ
  • NPI 1629592993
  NPD Authorized official

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

{
    "created_epoch": "1514505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1760572800000",
    "number": "1790292787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 PELICAN RD",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077483040",
            "telephone_number": "732-610-8396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "268 PELICAN RD",
            "city": "MIDDLETOWN",
            "state": "NJ",
            "postal_code": "077483040",
            "telephone_number": "732-610-8396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL COMMUNITY COUNSELING SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-29",
        "last_updated": "2025-10-16",
        "certification_date": "2025-10-16",
        "status": "A",
        "authorized_official_last_name": "ILLMENSEE",
        "authorized_official_first_name": "KELLIE",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "732-610-8396",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05738600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Y Cho, MD
• Cassandra Chojnowski
• Emily Cilla, DPT
• Joseph Clemente, M.D.
• Meghan E Clemente, ANP-C
• Kelley Lauren Coffman, M.D.
• Victoria Coglianese, RD
• Cognitaura LLC (Dba Fallor Clinic)
• Alison Jayne Coleman, LCSW
• Carolyn Collazo

• Clinical Social Worker in Middletown, NJ
• Providers in Middletown, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2025; 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.