Individual provider Active NPI

Georgianna Dorch, MS

  • Professional Counselor
  • Gulfport, MS
National Provider Identifier
1669979977
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
1617 25TH Ave
Gulfport, MS 39501-2834
Phone
(228) 324-4488
NPI assigned
Apr 12, 2018
Last updated
May 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 2696 MS
Professional Counselor 101YP2500X MS Primary

Addresses

Primary practice location

1617 25TH Ave
Gulfport, MS 39501-2834

Mailing address

1617 25TH Ave
Gulfport, MS 39501-2834
Phone (228) 324-4488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240312003338 MS Practitioner - Mental Health Counselor 2961848908 Practice locations: Gulfport, MS

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2696MSMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1669979977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 25TH AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012834",
            "telephone_number": "228-324-4488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1617 25TH AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012834",
            "telephone_number": "228-324-4488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORCH",
        "first_name": "GEORGIANNA",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-12",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MS",
            "license": "2696",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.