Provider Demographics
NPI:1487534376
Name:COASTAL COUNSELING COLLECTIVE, PROFESSIONAL CLINICAL COUNSELOR PC
Entity type:Organization
Organization Name:COASTAL COUNSELING COLLECTIVE, PROFESSIONAL CLINICAL COUNSELOR PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MACKENZIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCFARLAND
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:805-329-1234
Mailing Address - Street 1:PO BOX 3705
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93403-3705
Mailing Address - Country:US
Mailing Address - Phone:805-329-1234
Mailing Address - Fax:
Practice Address - Street 1:11549 LOS OSOS VALLEY RD STE 200
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-6483
Practice Address - Country:US
Practice Address - Phone:805-329-1234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-03
Last Update Date:2025-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty