GULF COAST MENTAL HEALTH CENTER NPI 1861715773

NPI Information

NPI: 1861715773
Provider Name: GULF COAST MENTAL HEALTH CENTER

Other Name: GULF COAST INDUSTRIES

Classification: Psychologist - 103TM1800X
Entity Type: Organization

Specialization: Intellectual and Developmental Disabilities

Address:
1600 BROAD AVE
GULFPORT, MS
ZIP 39501
Phone: (228) 863-1132
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GULF COAST MENTAL HEALTH CENTER is an intellectual and developmental disabilities in Gulfport, MS. GULF COAST MENTAL HEALTH CENTER NPI is 1861715773. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Gulf Coast Industries.

The provider's business location address is:

1600 BROAD AVE
GULFPORT, MS
ZIP 39501-603
Phone: (228) 863-1132
Fax: (228) 865-1700

The provider's authorized official is Debora J Stanovich .
The authorized official title is Credentials Specialist and has the following contact phone number (228) 863-1132.

The enumeration date for this NPI number is 3/5/2010 and was last updated on 10/21/2019.

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	103TM1800X	Psychologist	Intellectual and Developmental Disabilities	R13-1	MISSISSIPPI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00770456	MEDICAID	MISSISSIPPI

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: 5/5/2024

NPI Synchronization or Removal

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