ELENA MARIA FAIRLEY (NPI# 1548471188) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548471188 |
| Entity Type | Individual |
| Full Name | ELENA MARIA FAIRLEY |
| Credential | MS |
| Practice Address |
11352 Mia Cir Gulfport MS 39503-3882 |
| Practice Telephone | 2282650755 |
| Mailing Telephone | 2282650755 |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2017-02-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00018214 | 05 |
| Street Address |
11352 MIA CIR |
| City | GULFPORT |
| State | MS |
| Zip Code | 39503-3882 |
| 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 | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326564220 | Ashley Harris Whitfield | Counselor | 951 Cleveland Ave, Gulfport, MS 39507-3330 | 2017-08-22 |
| 1679011324 | Tiyahri Cheriece Wilson | Counselor | 1619 18th Ave, Gulfport, MS 39501-2131 | 2017-02-02 |
| 1184094005 | Jolene L Wilson | Counselor | 1607 24th Ave Ste A1, Gulfport, MS 39501-2970 | 2015-10-05 |
| 1386997096 | Melissa Lynne Roley | Counselor | 5121 27th Ave S, Gulfport, FL 33707-5413 | 2012-10-18 |
| 1376622423 | Louanna Claveau | Counselor | 450 East Pass Road, Suite 3, Gulfport, MS 39507 | 2006-11-02 |
| 1902453632 | Amanda Duran | Counselor | 302 Courthouse Rd Ste G, Gulfport, MS 39507-1890 | 2019-08-19 |
| 1821643990 | Shuida Haynes | Counselor | 302 Courthouse Rd Ste G, Gulfport, MS 39507-1890 | 2019-08-06 |
| 1801352182 | Devante Sago | Counselor | 302 Courthouse Rd Ste G, Gulfport, MS 39507-1890 | 2019-02-12 |
| 1366916462 | Felicia Faye Downs | Counselor | 302 Courthouse Rd Ste G, Gulfport, MS 39507-1890 | 2019-01-11 |
| 1861968182 | Lakeshia Fisher | Counselor | 302 Courthouse Rd Ste G, Gulfport, MS 39507-1890 | 2018-10-15 |
| Find all providers in GULFPORT | ||||
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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.