C Diane M Allgood, MSW, PCMHT
Individual provider Active NPI Mental Health Counselor · Gulfport, MS
NPI 1154885614 · NPPES record last updated Jan 29, 2019
Key facts
- NPI
- 1154885614
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- CH3255 (MS)
- Practice address
- 1600 Broad Ave
Gulfport, MS 39501-3603 - Phone
- (228) 863-1132
- Fax
- (228) 865-1780
- NPI assigned
- Jan 29, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CH3255 | MS | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CH3255 | MS | Yes |
Addresses
Primary practice location
1600 Broad Ave
Gulfport, MS 39501-3603
Mailing address
1600 Broad Ave
Gulfport, MS 39501-3603
Phone (228) 863-1132
Other providers in Gulfport, MS
- Rachel Evan Allen Rydbeck
- Latricia Rochelle Allen
- Laura Rae Allen
- Marsha M Allen
- Summer Lea Allen
- Russell Elbey Allman Jr.
- Edward Saunders Alpaugh
- Alberto L Alvarez
- Katherine Alvarez
- American Care Products , Inc.
All providers in Gulfport, MS · Mental Health Counselor in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.