Gulf Coast Play Therapy Clinic, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

2104 Issued in MS

Legal business name

GULF COAST PLAY THERAPY CLINIC, LLC

Practice address

370 Courthouse Rd Ste 102
Gulfport, MS 39507-1889

Phone

(228) 224-2258

Fax

(228) 896-1155

NPI assigned

Mar 28, 2017

Organization subpart

No

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

Authorized official

Name

Infanta Chantel White, ED.S., LPC, NCC, RPT

Title

Owner

Phone

(228) 697-7280

Specialties & licenses 1

Addresses

Other identifiers 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Infanta Chantel Noflin, EDS, LPC, NCC, RPT

  • Professional Counselor
  • Gulfport, MS
  • NPI 1427580612
  NPD

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1225560410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 COURTHOUSE RD STE 102",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395071889",
            "telephone_number": "228-224-2258",
            "fax_number": "228-896-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 COURTHOUSE RD STE 102",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395071889",
            "telephone_number": "228-224-2258",
            "fax_number": "228-896-1155"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 Oakridge Cir",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395072857",
            "country_code": "US",
            "telephone_number": "228-697-7280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GULF COAST PLAY THERAPY CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-28",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "INFANTA",
        "authorized_official_middle_name": "CHANTEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-697-7280",
        "authorized_official_credential": "ED.S., LPC, NCC, RPT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MS",
            "license": "2104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1427580612",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225560410",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gulf Coast Pediatric Care LLC
• Gulf Coast Pediatric Dentistry PLLC
• Gulf Coast Periodontics & Implants LLC
• Gulf Coast Physical Therapy Centers PA
• Gulf Coast Plastic Surgery
• Gulf Coast Psychotherapy
• Gulf Coast Recovery Clinic
• Gulf Coast Spinal & Neurosurgical Specialists
• Gulf Coast Spinal & Neurosurgical Specialists LLC
• Gulf Coast Value Cab

• All providers in Gulfport, MS
• Community/Behavioral Health Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.