Carrie Virginia Pate Therapy Center, LLC
Organization Active NPI Clinical Social Worker · Ocean Springs, MS
NPI 1013374347 · NPPES record last updated May 1, 2019
Key facts
- NPI
- 1013374347
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- C6890 (MS)
- Legal business name
- CARRIE VIRGINIA PATE THERAPY CENTER, LLC
- Practice address
- 2112 Bienville Blvd
Suite L-1
Ocean Springs, MS 39564-3052 - Phone
- (228) 990-8980
- Fax
- (228) 215-1721
- NPI assigned
- Jan 17, 2016
- Organization subpart
- No
Authorized official
- Name
- Ms. Carrie V Pate, LCSW
- Title
- Owner and Practitioner
- Phone
- (228) 990-8980
Practitioners 2
-
Carrie Virginia Pate, LCSW
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160209000119 | MS | Part B Supplier - Clinic/Group Practice | 1355645516 |
Receives reassigned benefits from 1 practitioner Practice locations: Ocean Springs, MS |
National Provider Directory
Locations
2112 Bienville Blvd
Ste L1
Ocean Springs, MS 39564
Phone (228) 990-8980
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker |
1041C0700X | C6890 | MS | Yes |
Addresses
Primary practice location
2112 Bienville Blvd
Suite L-1
Ocean Springs, MS 39564-3052
Mailing address
2112 Bienville Blvd
Suite L-1
Ocean Springs, MS 39564-3052
Phone (228) 215-1744
Other providers in Ocean Springs, MS
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- Charles Anthony Caplis
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- Christopher Carey
- Benjamin Carney
- James Moore Carter
- Thomas Boyd Carter
- Tracey Redina Carter
- Elizabeth Casey
- Nellissa Castillo
All providers in Ocean Springs, MS · Clinical Social Worker in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 1, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.