| Coastal Samaritan Counseling Center | |
|
1297 Professional Drive Ste 101 Myrtle Beach SC 29577-5713 | |
| (843) 448-4820 | |
| (843) 448-9875 |
| Full Name | Coastal Samaritan Counseling Center |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1297 Professional Drive, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Melinda P Tavernier (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8434484820 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Samaritan Counseling Center 1297 Professional Dr Ste 101 Myrtle Beach SC 29577-5713 Ph: (843) 448-4820 | Coastal Samaritan Counseling Center 1297 Professional Drive Ste 101 Myrtle Beach SC 29577-5713 Ph: (843) 448-4820 |
| NPI Number | 1922189679 |
|---|---|
| Provider Enumeration Date | 10/18/2006 |
| Last Update Date | 11/11/2025 |
| Certification Date | 11/11/2025 |
| Medicare PECOS PAC ID | 9537348487 |
|---|---|
| Medicare Enrollment ID | O20110124000992 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922189679 | NPI | - | NPPES |
| GP7630 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | () | Primary |
| Provider Name | Debra Carnosso |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194891127 PECOS PAC ID: 3476643594 Enrollment ID: I20150616000029 |
| Provider Name | Carol Ann Fletcher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295952232 PECOS PAC ID: 8426207895 Enrollment ID: I20161219000421 |
| Provider Name | June Tyson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902056211 PECOS PAC ID: 0446560403 Enrollment ID: I20211019002204 |
| Provider Name | Carol Jane Osment |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1154649986 PECOS PAC ID: 3173749751 Enrollment ID: I20240201001656 |
| Provider Name | Kelly S Gilmer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629689237 PECOS PAC ID: 1254774714 Enrollment ID: I20240212002995 |
| Provider Name | Stacy E Fraser |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285130625 PECOS PAC ID: 3971949470 Enrollment ID: I20240306003723 |
| Provider Name | Charlene K Koenig |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053194068 PECOS PAC ID: 4082114814 Enrollment ID: I20251209001204 |
Cognitive Behavioral Clinic LLC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 9403 Highway 707, Suite B, Myrtle Beach, SC 29588 Phone: 843-450-0636 Fax: 843-215-4561 |
Professional Counseling Associates, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1304 C Azalea Court, Myrtle Beach, SC 29577 Phone: 843-997-4022 Fax: 843-215-2444 |
Kenneth T Cappuccio LLC Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2195 Haystack Way, Myrtle Beach, SC 29579 Phone: 908-447-2913 |
Serenity and Beyond Counseling Services LLC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1229 38th Ave N Ste 207, Myrtle Beach, SC 29577 Phone: 843-804-8200 |
Enable My Child Ltd. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 22411 N Oak Street Suite 301l, Myrtle Beach, SC 29577 Phone: 888-511-7930 |
Seascape Insights LLC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1293 Professional Dr Ste A, Myrtle Beach, SC 29577 Phone: 843-284-3607 Fax: 843-839-9831 |