Organization Active NPI

Restoration Counseling Services, LLC

  • Clinical Social Worker
  • Gulfport, MS
National Provider Identifier
1679106967
Registry record updated Feb 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
RESTORATION COUNSELING SERVICES, LLC
Practice address
1403 43Rd Ave
Gulfport, MS 39501-2545
Phone
(601) 385-1235
Fax
(228) 241-0326
NPI assigned
Feb 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2020

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

Authorized official

Name
Sherri Lynne Sabin, LCSWNPI 1942833231
Title
Owner
Phone
(601) 385-1235

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

1403 43Rd Ave
Gulfport, MS 39501-2545

Mailing address

303 State St
Bay Saint Louis, MS 39520-4433
Phone (601) 385-1235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200320000270 MS Part B Supplier - Clinic/Group Practice 6608204995 Receives reassigned benefits from 1 practitioner
Practice locations: Gulfport, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1581724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581724800000",
    "number": "1679106967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 STATE ST",
            "city": "BAY SAINT LOUIS",
            "state": "MS",
            "postal_code": "395204433",
            "telephone_number": "601-385-1235",
            "fax_number": "228-241-0326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1403 43RD AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395012545",
            "telephone_number": "601-385-1235",
            "fax_number": "228-241-0326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-15",
        "last_updated": "2020-02-15",
        "certification_date": "2020-02-15",
        "status": "A",
        "authorized_official_last_name": "SABIN",
        "authorized_official_first_name": "SHERRI",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-385-1235",
        "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": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2020; 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.