Provider Demographics
NPI:1538828181
Name:COASTAL THERAPY AND WELLNESS
Entity type:Organization
Organization Name:COASTAL THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JOSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RHOADS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:561-461-0113
Mailing Address - Street 1:7040 SEMINOLE PRATT WHITNEY RD # 25-141
Mailing Address - Street 2:
Mailing Address - City:LOXAHATCHEE
Mailing Address - State:FL
Mailing Address - Zip Code:33470-5714
Mailing Address - Country:US
Mailing Address - Phone:561-461-0113
Mailing Address - Fax:
Practice Address - Street 1:7040 SEMINOLE PRATT WHITNEY RD # 25-141
Practice Address - Street 2:
Practice Address - City:LOXAHATCHEE
Practice Address - State:FL
Practice Address - Zip Code:33470-5714
Practice Address - Country:US
Practice Address - Phone:561-461-0113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-10
Last Update Date:2021-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty