GULF COAST NEUROPSYCHOLOGY, LLC (NPI# 1194028555) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194028555 |
| Entity Type | Organization |
| Organization Name | GULF COAST NEUROPSYCHOLOGY, LLC |
| Practice Address |
16195c Landon Rd Gulfport MS 39503-4121 |
| Mailing Address |
45 Hardy Court Ctr #113 Gulfport MS 39507-2501 |
| Practice Telephone | 2283857733 |
| Mailing Telephone | 2283857733 |
| Mailing Fax Number | 2285391464 |
| Enumeration Date | 2010-12-07 |
| Last Update Date | 2010-12-07 |
| Authorized Official Name | DR. DEBRA SUE WEITZEL (OWNER) |
| Authorized Official Telephone | 2283857733 |
| Authorized Official Credential | PH.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 45-725 | MS | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972039584 | Gulf Coast Neuropsychology, LLC | Clinical Neuropsychologist | 2650 Bahia Vista St, Suite 201, Sarasota, FL 34239-2635 | 2017-05-03 |
| 1639516750 | Gulf Coast Neuropsychology, LLC | Psychologist | 2650 Bahia Vista St, Suite 201, Sarasota, FL 34239-2635 | 2013-05-30 |
| Street Address |
16195C LANDON RD |
| City | GULFPORT |
| State | MS |
| Zip Code | 39503-4121 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013515451 | Gulf Coast Neurospa, LLC | Psychiatry & Neurology | 8845 Lorraine Road, Gulfport, MS 39503 | 2020-10-16 |
| 1447865985 | Nicholas Wyrosdick | Physical Therapist | 12261 Us 49 #1, Gulfport, MS 39503 | 2020-09-11 |
| 1750935169 | Ladner Roy Drugs, LLC. | Pharmacy | 12261 Us 49 Suite 16, Gulfport, MS 39503 | 2019-07-25 |
| 1528559440 | Alexander Therapy Services, LLC | Clinic/Center | 15465 Oak Ln Ste 100c, Gulfport, MS 39503 | 2018-05-25 |
| 1750879003 | Heather Lynn Theisen | Nurse Practitioner | 15190 Community Rd Ste 330, Gulfport, MS 39503 | 2018-04-23 |
| 1083101216 | Gulf Coast Mental Health Center | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 15094 County Barn Road, Gulfport, MS 39503 | 2018-04-13 |
| 1306343173 | Dr. Raymond Monsour Scurfield, LLC | Community/Behavioral Health | 15465 Oak Lane Ste 100-g, Gulfport, MS 39503 | 2018-04-09 |
| 1952817157 | Mary Beth Welch | Behavioral Analyst | 9230 Old Lorraine Rd, Gulfport, MS 39503 | 2017-12-26 |
| 1831603257 | Beach View Family Dental, Pllc | Dentist | 9072 Lorraine Road, Gulfport, MS 39503 | 2017-11-21 |
| 1437677721 | Mary Stephens Ruffin | Social Worker | 11262 Creek Dr, Gulfport, MS 39503 | 2017-09-07 |
| Find all providers in zip 39503 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598823809 | Karen Lundin | Clinical Neuropsychologist | 15190 Community Rd, Suite 260, Gulfport, MS 39503-3485 | 2006-12-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073093894 | Virginia Catherine Persinger | Clinical Neuropsychologist | 1350 E Woodrow Ave, Jackson, MS 39216-5112 | 2018-08-21 |
| 1780963793 | Joy Humphreys Clark | Clinical Neuropsychologist | 1350 E. Woodrow Wilson, Jackson, MS 39216-5112 | 2011-08-08 |
| 1871818369 | Brian Heath Gordon | Clinical Neuropsychologist | 357 Towne Center Blvd Ste 403, Ridgeland, MS 39157-4844 | 2010-03-29 |
| 1699968453 | Ethel Wiest Hetrick | Clinical Neuropsychologist | 412 Highway 90, Suite 10, Bay Saint Louis, MS 39520-3534 | 2007-08-23 |
| 1922210103 | Kevin J. Mccarthy | Clinical Neuropsychologist | 415 W Canal St, Picayune, MS 39466-3912 | 2007-05-03 |
| 1518049238 | Andrea Lyn Todd | Clinical Neuropsychologist | 542 Arbor Station Dr, Long Beach, MS 39560-5741 | 2006-10-20 |
| 1720022973 | William Brian Thomas | Clinical Neuropsychologist | 144 S Thomas St Ste 104a, Tupelo, MS 38801-5337 | 2006-06-16 |
| 1285614370 | Samuel E. Fleming IIi | Clinical Neuropsychologist | 211 N Madison St, Tupelo, MS 38804-3807 | 2006-01-17 |
| 1124527841 | Clinical & Forensic Neuropsychology Services LLC | Clinical Neuropsychologist | 357 Towne Center Blvd Ste 403, Ridgeland, MS 39157-4844 | 2018-02-08 |
| 1023402047 | Nancy H. Goldman, LLC | Clinical Neuropsychologist | 3000 Old Canton Rd, Suite 465, Jackson, MS 39216-4200 | 2015-03-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.