Provider Demographics
NPI:1417756321
Name:COASTAL CALM COUNSELING LLC
Entity type:Organization
Organization Name:COASTAL CALM COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH CLINICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MIKAYLA
Authorized Official - Middle Name:T
Authorized Official - Last Name:BOUSQUET
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:508-233-8257
Mailing Address - Street 1:225 WATER ST STE A105
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-4061
Mailing Address - Country:US
Mailing Address - Phone:508-233-8257
Mailing Address - Fax:
Practice Address - Street 1:225 WATER ST STE A105
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4061
Practice Address - Country:US
Practice Address - Phone:508-233-8257
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)