Coastal Counseling Associates, PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1680 Issued in NC

Legal business name

COASTAL COUNSELING ASSOCIATES, PLLC

Practice address

115 Hinton Ave
Suite 7
Wilmington, NC 28403-4785

Phone

(910) 350-0004

Fax

(910) 350-1206

NPI assigned

Sep 24, 2007

Last updated

Jan 25, 2012By 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

Dr. Richard Charles Campbell, PH.D.NPI 1124157599

Title

Partner

Phone

(910) 350-0004

Specialties & licenses 1

Addresses

Other identifiers 1

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.

• Richard Charles Campbell, PH.D.

  • Clinical Psychologist
  • Wilmington, NC
  • NPI 1124157599
  Authorized official Same address or phone

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

{
    "created_epoch": "1190592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327449600000",
    "number": "1891981866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 HINTON AVE",
            "address_2": "SUITE 7",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034785",
            "telephone_number": "910-350-0004",
            "fax_number": "910-350-1206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 HINTON AVE",
            "address_2": "SUITE 7",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284034785",
            "telephone_number": "910-350-0004",
            "fax_number": "910-350-1206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL COUNSELING ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-24",
        "last_updated": "2012-01-25",
        "status": "A",
        "authorized_official_last_name": "CAMPBELL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "910-350-0004",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "1680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000486",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coastal Childrens Services PLLC (CCS Wilmington)
• Coastal Childrens Services PLLC
• Coastal Chiropractic Center PA
• Coastal Community Care Services LLC
• Coastal Connections Collective, PLLC
• Coastal Dermatology & Surgery Center, PA
• Coastal Enterprises of Wilmington
• Coastal Eyeworks Incorporated (Ogden Optical Center)
• Coastal Family Practice & Internal Medicine
• Coastal Healing PA

• Clinical Psychologist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2012; 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.