Coastal Samaritan Counseling Center
Organization Active NPI Community/Behavioral Health Agency · Myrtle Beach, SC
NPI 1922189679 · NPPES record last updated Nov 11, 2025
Key facts
- NPI
- 1922189679
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- COASTAL SAMARITAN COUNSELING CENTER
- Practice address
- 1297 Professional Drive
Ste 101
Myrtle Beach, SC 29577-5713 - Phone
- (843) 448-4820
- Fax
- (843) 448-9875
- NPI assigned
- Oct 18, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Melinda P Tavernier, EDD
- Title
- Executive Director
- Phone
- (843) 448-4820
Practitioners 28
-
Debra Anne Carnosso, LCSW-R AND LISW-CP
-
Carol Jane Osment, M.A., M.DIV,
-
Charlene Koenig, MA
-
Carol Ann Fletcher, MSW
-
June Tyson, LCSW-R
-
Kelly Sue Gilmer, LPC
-
Rori Bailey, BA, LPCA
-
Jeannie James, LPC, LAC
-
Carmen Lee Royall, LPC
-
William H Felder, LPC
-
Janet Irene Filipow, LPC
-
Ellalee F. Gravely, LPC, NCC
-
Jean Hankins, LPC
-
Sharon Yvette Harms, MSW INTERN
-
Franklin McCollum, LPC-A, AADC-IP
-
Joan Carlene Roberts, LPC
-
Gretchen A. Smith, MSW, LISW-CP
-
Stefan Sultanov, MAINTERN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110124000992 | SC | Part B Supplier - Clinic/Group Practice | 9537348487 |
Receives reassigned benefits from 7 practitioners Practice locations: Myrtle Beach, SC |
National Provider Directory
Locations
198 Long Ave
Conway, SC 29526
Phone (843) 448-4820
901 N Kings Hwy
Myrtle Beach, SC 29577
Phone (843) 448-4820
1297 Professional Dr
Ste 101
Myrtle Beach, SC 29577
Phone (843) 448-4820
180 Saint Pauls Pl
Pawleys Island, SC 29585
Phone (843) 448-4820
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
1297 Professional Drive
Ste 101
Myrtle Beach, SC 29577-5713
Mailing address
1297 Professional Dr Ste 101
Myrtle Beach, SC 29577-5713
Phone (843) 448-4820
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP7630 | Medicaid | SC |
Other providers in Myrtle Beach, SC
- Coastal Podiatry Associates PA
- Coastal Podiatry Associates, PA
- Coastal Recovery & Wellness, LLC
- Coastal Rejuvenation Solutions
- Coastal Renal Care
- Coastal Sleep Lab, Inc
- Coastal Springs Counseling LLC
- Coastal Wellness Center, LLC
- Chrystal M Coates-Gal
- Stephanie C. Cobb
All providers in Myrtle Beach, SC · Community/Behavioral Health Agency in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.