COASTAL ADDICTION RECOVERY LLC (NPI# 1942701792) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942701792 |
| Entity Type | Organization |
| Organization Name | COASTAL ADDICTION RECOVERY LLC |
| Practice Address |
2179 Ashley Phosphate Rd Ste B North Charleston SC 29406-4180 |
| Practice Telephone | 8437183168 |
| Mailing Telephone | 8437183168 |
| Enumeration Date | 2018-02-27 |
| Last Update Date | 2018-02-27 |
| Authorized Official Name | MRS. JODI MOORE (EXECUTIVE ADMINISTRATOR) |
| Authorized Official Telephone | 8643032499 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | Behavioral Health & Social Service Providers | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083184576 | Coastal Addiction Recovery LLC | Clinic/Center | 2179 Ashley Phosphate Rd Ste B, North Charleston, SC 29406-4180 | 2018-11-28 |
| Street Address |
2179 ASHLEY PHOSPHATE RD STE B |
| City | NORTH CHARLESTON |
| State | SC |
| Zip Code | 29406-4180 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437319266 | Todd Keith Magro | Psychiatry & Neurology | 2179 Ashley Phosphate Rd Ste B, North Charleston, SC 29406 | 2008-06-16 |
| 1083184576 | Coastal Addiction Recovery LLC | Clinic/Center | 2179 Ashley Phosphate Rd Ste B, North Charleston, SC 29406-4180 | 2018-11-28 |
| 1871878595 | Alliance Medical Group | Family Medicine | 2179 Ashley Phosphate Rd Ste B, North Charleston, SC 29406-4180 | 2011-10-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023622289 | Sara Desmarais | Physical Therapist | 2760 Tricom St, North Charleston, SC 29406 | 2020-09-04 |
| 1669036448 | Pink Elephant Autism Project | In Home Supportive Care | 8738 Red Oak Drive, Charleston, SC 29406 | 2019-04-26 |
| 1083171185 | Medical University Hospital Authority | Pharmacy | 2250 Mall Drive, North Charleston, SC 29406 | 2019-02-25 |
| 1336627371 | Truesdale Medical Center LLC | Internal Medicine | 6296 Rivers Ave., Suite 310, N. Charleston, SC 29406 | 2018-08-01 |
| 1164914552 | Amanda R Dipiazza | Nurse Anesthetist, Certified Registered | 9330 Medical Plaza Dr Ste E, Charleston, SC 29406 | 2018-06-01 |
| 1982148490 | Trident Medical Center | Psychiatric Hospital | 9225 C Medical Plaza Drive, Charleston, SC 29406 | 2016-12-19 |
| 1649726217 | First Choice Counseling Services, LLC | Community/Behavioral Health | 2245 Greenridge Rd., Unit#414, North Charleston, SC 29406 | 2016-09-01 |
| 1821443896 | Liberty Doctors, LLC | Family Medicine | 9275 D Medical Plaza Dr., North Charleston, SC 29406 | 2016-04-27 |
| 1174984645 | Ashia George | Developmental Therapist | 6650 Rivers Avenue, Ste 100, Charleston, SC 29406 | 2016-03-11 |
| 1023488582 | Etta Smith | Counselor | 2470 Mall Dr Unit Cd, North Charleston, SC 29406 | 2015-09-28 |
| Find all providers in zip 29406 | ||||
| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982037529 | Charleston Addiction Medicine, LLC | Psychiatry & Neurology | 2175 Ashley Phosphate Rd, Suite G, North Charleston, SC 29406-4181 | 2013-08-19 |
| 1558663294 | Michael J Huggins | Psychiatry & Neurology | 2175 Ashley Phosphate Rd, Suite G, North Charleston, SC 29406-4181 | 2010-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093280620 | Capeside Addiction Care, Pllc | Psychiatry & Neurology | 4889 Highway 17 Byp S, Myrtle Beach, SC 29577-6683 | 2018-10-10 |
| 1205996303 | Susan Jayne Olson | Psychiatry & Neurology | 1297 Professional Dr, Ste 104, Myrtle Beach, SC 29577-5713 | 2006-12-11 |
| 1104101054 | South Carolina Research Group LLC | Psychiatry & Neurology | 68 Parkway Commons Way, Greer, SC 29650-5213 | 2011-10-11 |
| 1164746392 | Anmed Health | Psychiatry & Neurology | 800 N Fant St, Anderson, SC 29621-5708 | 2010-03-17 |
| 1922203223 | Joseph David Markowitz | Psychiatry & Neurology | 3555 Harden Street Ext Ste 141, Columbia, SC 29203 | 2007-06-18 |
| 1396957445 | Robert Holden Stafford | Psychiatry & Neurology | 910 Cook Rd, Orangeburg, SC 29118-2124 | 2007-05-03 |
| 1538229448 | Strand Psychiatric Associates Pa | Psychiatry & Neurology | 3025 Newcastle Loop, Myrtle Beach, SC 29588-4502 | 2006-12-11 |
| 1295824159 | Spartanburg Medical Center | Psychiatry & Neurology | 391 Serpentine Dr, Suite 400, Doctor's Center, Spartanburg, SC 29303-3096 | 2006-10-11 |
| 1750481727 | Faraz Qureshi | Psychiatry & Neurology | 109 Bee St, Charleston, SC 29401-5703 | 2006-09-22 |
| 1275643538 | Diana L. Thorne | Psychiatry & Neurology | 6439 Garners Ferry Rd, Columbia, SC 29209-1638 | 2006-08-30 |
| Find all providers with the same taxonomy | ||||
| City | NORTH CHARLESTON |
| Zip Code | 29406 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.