NPIMap

Organization Active NPI

Coastal Samaritan Counseling Center

  • Community/Behavioral Health Agency
  • Myrtle Beach, SC
National Provider Identifier
1922189679
Registry record updated Nov 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 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
Last updated
Nov 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2025

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

Authorized official

Name
Dr. Melinda P Tavernier, EDD
Title
Executive Director
Phone
(843) 448-4820

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

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 1

IdentifierTypeStateIssuer
GP7630MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110124000992 SC Part B Supplier - Clinic/Group Practice 9537348487 Receives reassigned benefits from 7 practitioners
Practice locations: Myrtle Beach, SC

National Provider Directory

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

180 Saint Pauls Pl
Pawleys Island, SC 29585
Phone (843) 448-4820

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762819200000",
    "number": "1922189679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1297 PROFESSIONAL DR STE 101",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775713",
            "telephone_number": "843-448-4820",
            "fax_number": "843-448-9875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1297 PROFESSIONAL DRIVE",
            "address_2": "STE 101",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295775713",
            "telephone_number": "843-448-4820",
            "fax_number": "843-448-9875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL SAMARITAN COUNSELING CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2025-11-11",
        "certification_date": "2025-11-11",
        "status": "A",
        "authorized_official_last_name": "TAVERNIER",
        "authorized_official_first_name": "MELINDA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "843-448-4820",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "EDD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP7630",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Myrtle Beach, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2025; 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.