Gulf Coast Behavioral Health, LLC

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

GULF COAST BEHAVIORAL HEALTH, LLC

Practice address

37283 Swamp Rd Ste 803
Prairieville, LA 70769-3329

Phone

(225) 254-9589

Fax

(225) 208-7267

NPI assigned

May 9, 2022

Last updated

Mar 31, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cristy Stibal

Title

Director of Operations

Phone

(208) 821-1032

Specialties & licenses 11

Addresses

Other names 1

• Gulf Coast Behavioral Health Former legal business name

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica Ezejimofor, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Prairieville, LA
  • NPI 1891500765
  Medicare reassignment NPD
• Tina Duncan Malonson, APRN, FNP-C

  • Psychiatric/Mental Health Nurse Practitioner
  • Slidell, LA
  • NPI 1902437270
  Medicare reassignment NPD
• Monique Pierre Williams, DNP, APRN, FNP/PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Baton Rouge, LA
  • NPI 1588184220
  Medicare reassignment NPD
• Karl Winegar, LCSW

  • Clinical Social Worker
  • Prairieville, LA
  • NPI 1780138206
  Medicare reassignment NPD
• Megan A. Moran, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Bogalusa, LA
  • NPI 1962266114
  Medicare reassignment
• Sarah Elaine Allee, MSW, LMSW

  • Clinical Social Worker
  • Baton Rouge, LA
  • NPI 1538942768
  NPD
• Aaron Anderson, CSW

  • Social Worker
  • Prairieville, LA
  • NPI 1922999697
  NPD
• Justin Park

  • Counselor
  • Prairieville, LA
  • NPI 1356867477

  Multi-Specialty

  NPD
• Quinn S Millington, DPT

  • Clinical Electrophysiology Physical Therapist
  • Pike Road, AL
  • NPI 1174573844
  NPD
• Brennan Young, PT

  • Physical Therapist
  • Franklin, LA
  • NPI 1003595745
  NPD (past)
• Lauren H. Grawert, MD

  • Psychiatry Physician
  • Loma Linda, CA
  • NPI 1508093543
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680220800000",
    "number": "1043956527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37283 SWAMP RD STE 803",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707693329",
            "telephone_number": "225-254-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37283 SWAMP RD STE 803",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707693329",
            "telephone_number": "225-254-9589",
            "fax_number": "225-208-7267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST BEHAVIORAL HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-09",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A",
        "authorized_official_last_name": "STIBAL",
        "authorized_official_first_name": "CRISTY",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "208-821-1032"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gulf Coast Behavioral Health",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Gulf Coast Behavioral Health",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Krissy Ayo Guedry, LPC
• Jennifer C Gueho, ANP
• Paige Guercio, PLPC
• Etheila Guient
• Christy Guilott
• Samantha Gulino, M.D.
• Jessica Karner Gunning
• Abigail Haile
• Erica Hall
• India Elise Hall

• Substance Abuse Rehabilitation Facility in Prairieville, LA
• Providers in Prairieville, LA by specialty
• Substance Abuse Rehabilitation Facility in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.