Seaside Psychotherapy Gulf Coast

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SEASIDE PSYCHOTHERAPY GULF COAST

Practice address

2113 Government St Ste I-2E
Ocean Springs, MS 39564-3954

Phone

(228) 222-8006

NPI assigned

Aug 14, 2019

Organization subpart

No

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

Authorized official

Name

Ashley P Pearson, LCSWNPI 1134296809

Title

Owner

Phone

(504) 319-2837

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

Practitioners 1

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

• Ashley Pugeau Pearson, LCSW

  • Clinical Social Worker
  • Ocean Springs, MS
  • NPI 1134296809
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1568505600000",
    "number": "1265088306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3818 CHAUMONT CIR",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395648539",
            "telephone_number": "504-319-2837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2113 GOVERNMENT ST STE I-2E",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395643954",
            "telephone_number": "228-222-8006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE PSYCHOTHERAPY GULF COAST",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-14",
        "last_updated": "2019-09-15",
        "status": "A",
        "authorized_official_last_name": "PEARSON",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-319-2837",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Ocean Springs, MS
• Providers in Ocean Springs, MS by specialty
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.