Organization · NPI-2

Coastal Carolina Neuropsychiatric Center, PA

Psychiatry & Neurology, Psychiatry · Jacksonville, NC

NPI number1184737462
StatusActive
Last updated in NPPESAug 5, 2020

Details

NPI
1184737462
Entity type
Organization (NPI-2)
Legal business name
Coastal Carolina Neuropsychiatric Center, PA
Organization subpart
No
Enumeration date
Aug 17, 2006
Certification date
Aug 5, 2020
Last updated
Aug 5, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2084P0800X Psychiatry & Neurology, Psychiatry––Yes
101Y00000X Counselor––
103T00000X Psychologist––
207Q00000X Family Medicine––
207RC0000X Internal Medicine, Cardiovascular Disease––
2084N0400X Psychiatry & Neurology, Neurology––

Practice location

200 Tarpon Trail
Jacksonville, NC 28546-5266

Phone 910-938-1114 · Fax 910-938-1118

Mailing address

200 Tarpon Trail
Jacksonville, NC 28546-5266

Phone 910-938-1114 · Fax 910-938-1118

Other practice locations

400 Liberty Hill Rd
Lumberton, NC 28358-2446

Phone 910-938-1114 · Fax 910-938-1118

1200 Fairmont Ct
Fayetteville, NC 28304-4403

Phone 910-938-1114 · Fax 910-938-1118

302 Penny Ln
Morehead City, NC 28557-4306

Phone 910-938-1114 · Fax 910-938-1118

1630 Military Cutoff Rd Ste 108
Wilmington, NC 28403-5719

Phone 910-938-1114 · Fax 910-938-1118

Authorized official

Carla Mikhail
Practice Administrator
9109381114

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