34D2042358 CLIA NUMBER - COASTAL CAROLINA NEURO PSYCHIATRIC CENTER

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Laboratory Demographics

CLIA Number: 34D2042358

Facility Name: COASTAL CAROLINA NEURO PSYCHIATRIC CENTER

Facility Address:
1200 FAIRMONT COURT
FAYETTEVILLE, NC
ZIP 28304
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Facility Phone Number: 910 938-1114

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1184737462

Taxonomy: 2084P0800X - Psychiatry & Neurology
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

CLIA Record

Field Name	Field Value
CLIA Number	34D2042358
LAB Type	Practitioner Other
Facility Name	COASTAL CAROLINA NEURO PSYCHIATRIC CENTER
Street	1200 FAIRMONT COURT
City	FAYETTEVILLE
State	NC
ZIP	28304
Phone	910 938-1114
CertificateType	4
CertificateEffectiveDate	6/11/2022
CertificateExpirationDate	6/10/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024