Georgianna Dorch, MS
Individual provider Active NPI Professional Counselor · Gulfport, MS
NPI 1669979977 · NPPES record last updated May 9, 2024
Key facts
- NPI
- 1669979977
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- Practice address
- 1617 25TH Ave
Gulfport, MS 39501-2834 - Phone
- (228) 324-4488
- NPI assigned
- Apr 12, 2018
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240312003338 | MS | Practitioner - Mental Health Counselor | 2961848908 | Practice locations: Gulfport, MS |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 2696 | MS | |
| Professional Counselor | 101YP2500X | MS | Yes |
Addresses
Primary practice location
1617 25TH Ave
Gulfport, MS 39501-2834
Mailing address
1617 25TH Ave
Gulfport, MS 39501-2834
Phone (228) 324-4488
Other providers in Gulfport, MS
- Catherine N Donald
- Donn E Bowers MD Apmc
- Donna Burrowes, PLLC
- Robert Favret Donner
- Bobbi Nicole Donovan
- Raymond Kimble Doty Jr.
- John William Douglas
- Kristen Mullins Douglas
- Felicia Faye Downs
- Danae Doyle
All providers in Gulfport, MS · Professional 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 May 9, 2024. 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.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.