Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Coastal Neurotherapy, PA

Organization Clinical Neuropsychologist · NPI 1528353729

Coastal Neurotherapy, PA is a Clinical Neuropsychologist in Jacksonville, North Carolina. Licensed in North Carolina. Registered with an NPI since 2011.

Licensed in
NC
In the registry since
2011
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

200 Valencia Dr Ste 109
Jacksonville, NC 28546-6311
Phone: (910) 353-1760
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Neuropsychologist (primary) Taxonomy 103G00000X · Licence 3745 (NC)

Record details

NPI number1528353729
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official David Hagedorn — President/Owner · (910) 353-1760
NPI enumeratedJune 15, 2011
Last updated in NPPESJune 15, 2011
Mailing address200 Valencia Dr, Suite 109, Jacksonville, NC 28546-6311

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