OrganizationActive
Coastal Addiction Recovery LLC
NPI 1942701792 · Addiction Medicine (Psychiatry & Neurology) Physician · North Charleston, SC
Provider details
- NPI number
- 1942701792
- Entity type
- Organization
- Primary specialty
- Addiction Medicine (Psychiatry & Neurology) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jodi Moore, Executive Administrator(864) 303-2499
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Counselor101Y00000X
Behavioral Health & Social Service Providers
- Psychiatry Physician2084P0800X
Allopathic & Osteopathic Physicians
- Addiction Psychiatry Physician2084P0802X
Allopathic & Osteopathic Physicians
Behavioral Health & Social Service Providers
- Mental Health Counselor101YM0800X
Behavioral Health & Social Service Providers
- Marriage & Family Therapist106H00000X
Practice location
2179 Ashley Phosphate Rd Ste B
North Charleston, SC 29406-4180
Phone: (843) 718-3168
Approximate (ZIP-level) locationGet directions
Mailing address
2179 Ashley Phosphate Rd Ste B
North Charleston, SC 29406-4180
Registry dates
- Enumerated
- 2018-02-27
- Last updated
- 2018-02-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.