| Coastal Synergy Associates | |
|
14646 Compass St Ste 10 Corpus Christi TX 78418 | |
| (361) 852-0988 | |
| (361) 687-2563 |
| Full Name | Coastal Synergy Associates |
|---|---|
| Speciality | Counselor |
| Location | 14646 Compass St Ste 10, Corpus Christi, Texas |
| Authorized Official Name and Position | Shana Hisaw (OWNER) |
| Authorized Official Contact | 3618671059 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Synergy Associates 14646 Compass St Ste 10 Corpus Christi TX 78418-6232 Ph: (361) 852-0988 | Coastal Synergy Associates 14646 Compass St Ste 10 Corpus Christi TX 78418 Ph: (361) 852-0988 |
| NPI Number | 1437520418 |
|---|---|
| Provider Enumeration Date | 10/15/2015 |
| Last Update Date | 09/28/2023 |
| Certification Date | 09/28/2023 |
| Medicare PECOS PAC ID | 6002118403 |
|---|---|
| Medicare Enrollment ID | O20151231000217 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437520418 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Shana Hisaw |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104014539 PECOS PAC ID: 3971776485 Enrollment ID: I20231122001621 |
| Provider Name | Stacie Celene Morgan |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194473314 PECOS PAC ID: 9436507365 Enrollment ID: I20231201002850 |
| Provider Name | Cynthia Louise Bonifer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326656588 PECOS PAC ID: 0042668857 Enrollment ID: I20231204002500 |
| Provider Name | Ashleigh Forney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1174235410 PECOS PAC ID: 9436507266 Enrollment ID: I20231204003252 |
| Provider Name | Joseph William Leonard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194485565 PECOS PAC ID: 7719336304 Enrollment ID: I20231207002426 |
| Provider Name | Laurie Brewer Downey |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710247135 PECOS PAC ID: 1658645650 Enrollment ID: I20231229000847 |
| Provider Name | Laura Heil Montoya |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922560192 PECOS PAC ID: 0648623538 Enrollment ID: I20240126002307 |
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