| Coastal Wellness Llc | |
| 
					105 Webster St Ste 5 Hanover MA 02339-1227  | |
| (508) 353-9602 | |
| Not Available | 
| Full Name | Coastal Wellness Llc | 
|---|---|
| Speciality | Social Worker | 
| Location | 105 Webster St Ste 5, Hanover, Massachusetts | 
| Authorized Official Name and Position | Courtney Flanagan-faber (LCSW) | 
| Authorized Official Contact | 5083539602 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Coastal Wellness Llc 105 Webster St Ste 5 Hanover MA 02339-1227 Ph: (508) 353-9602  | Coastal Wellness Llc 105 Webster St Ste 5 Hanover MA 02339-1227 Ph: (508) 353-9602  | 
| NPI Number | 1730699471 | 
|---|---|
| Provider Enumeration Date | 10/09/2017 | 
| Last Update Date | 07/21/2022 | 
| Medicare PECOS PAC ID | 5698036622 | 
|---|---|
| Medicare Enrollment ID | O20180307001953 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1730699471 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary | 
| Provider Name | Courtney L Flanagan Faber | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1437280278 PECOS PAC ID: 3173701349 Enrollment ID: I20110617000554  | 
| Provider Name | Glenn Meunier | 
|---|---|
| Provider Type | Practitioner - Clinical Social Worker | 
| Provider Identifiers | NPI Number: 1912204686 PECOS PAC ID: 9133307705 Enrollment ID: I20110630000025  | 
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