GULF COAST PSYCHOTHERAPY NPI 1417147398

NPI Information

NPI: 1417147398
Provider Name: GULF COAST PSYCHOTHERAPY
Classification: Counselor - 101YM0800X
Entity Type: Organization

Specialization: Mental Health

CLIA Number: 25D1105421

Address:
12231A ASHLEY DR
GULFPORT, MS
ZIP 39503
Phone: (228) 832-2400
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GULF COAST PSYCHOTHERAPY is a mental health counselor in Gulfport, MS. GULF COAST PSYCHOTHERAPY NPI is 1417147398. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

12231A ASHLEY DR
GULFPORT, MS
ZIP 39503-775
Phone: (228) 832-2400
Fax: (228) 832-2431

The provider's authorized official is Jean R Pacher .
The authorized official title is Owner and has the following contact phone number (228) 832-2400.

The CLIA number assigned to this NPI record is 25D1105421 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/27/2007 and was last updated on 7/27/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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