COASTAL INTEGRATIVE WELLNESS A MARRIAGE AND FAMILY CORP NPI 1477232932

NPI Information

NPI: 1477232932
Provider Name: COASTAL INTEGRATIVE WELLNESS, A MARRIAGE AND FAMILY CORP
Classification: Marriage & Family Therapist - 106H00000X
Entity Type: Organization
Address: 3889 LONG ST STE 200
SAN LUIS OBISPO, CA
ZIP 93401
Phone: (805) 724-6831

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NPI Details

COASTAL INTEGRATIVE WELLNESS, A MARRIAGE AND FAMILY CORP is a marriage family therapist in San Luis Obispo, CA. The provider is a marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. COASTAL INTEGRATIVE WELLNESS, A MARRIAGE AND FAMILY CORP NPI is 1477232932. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3889 LONG ST STE 200
SAN LUIS OBISPO, CA
ZIP 93401-581
Phone: (805) 724-6831

The provider's authorized official is Leah Derose .
The authorized official title is President and has the following contact phone number (805) 724-6831.

The enumeration date for this NPI number is 7/12/2023 and was last updated on 7/12/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	103T00000X	Psychologist		No
2	251B00000X	Case Management		No
3	261Q00000X	Clinic/Center		No
4	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
5	261QM0850X	Clinic/Center	Adult Mental Health	No
6	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	No
7	363A00000X	Physician Assistant		No
8	106H00000X	Marriage & Family Therapist		Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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