Coastal Virginia Psychological Associates

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810001135 Issued in VA

Legal business name

COASTAL VIRGINIA PSYCHOLOGICAL ASSOCIATES

Practice address

333 Kellam Rd Ste 100
Virginia Beach, VA 23462

Phone

(757) 499-1694

Fax

(757) 499-1696

NPI assigned

Apr 8, 2015

Last updated

Aug 9, 2018By 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

Ms. Nicole M Starling

Title

Office Manager

Phone

(757) 499-1694

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Tax ID family

Coastal Virginia Psychological Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Errol Liebowitz PHD

  dba Coastal Virginia Psychological Associates

  • Clinical Psychologist
  • Virginia Beach, VA
  • NPI 1083648331
  NPD tax ID

Locations

Practitioners 2

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.

• Errol E Liebowitz, PHD

  • Clinical Psychologist
  • Virginia Beach, VA
  • NPI 1457304115
  Medicare reassignment NPD
• Nicole B Coulter, MS, RESIDENT

  • Counselor
  • Virginia Beach, VA
  • NPI 1265943336
  NPD (past)

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533772800000",
    "number": "1982090882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 KELLAM RD STE 340",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234622746",
            "telephone_number": "757-499-1694",
            "fax_number": "757-499-1696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 KELLAM RD STE 100",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "23462",
            "telephone_number": "757-499-1694",
            "fax_number": "757-499-1696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL VIRGINIA PSYCHOLOGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-08",
        "last_updated": "2018-08-09",
        "status": "A",
        "authorized_official_last_name": "STARLING",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "757-499-1694",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810001135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Delene Coates
• Mikel E Coates, IDC
• Emma Grace Coats

• Clinical Psychologist in Virginia Beach, VA
• Providers in Virginia Beach, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; 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.