Resilience Psychotherapy, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

RESILIENCE PSYCHOTHERAPY, PLLC

Practice address

3427 Washington Ave
Gulfport, MS 39507-3039

Phone

(888) 464-1811

Fax

(800) 416-3070

NPI assigned

Aug 6, 2018

Organization subpart

No

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

Authorized official

Name

Cori L Walker, LCSWNPI 1851808893

Title

Managing Member

Phone

(888) 464-1811

Specialties & licenses 2

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.

• Cori L Walker, LCSW

  • Clinical Social Worker
  • Gulfport, MS
  • NPI 1851808893

  Mental Health, MS

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1533513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642464000000",
    "number": "1720566201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3427 WASHINGTON AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395073039",
            "telephone_number": "888-464-1811",
            "fax_number": "800-416-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3427 WASHINGTON AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395073039",
            "telephone_number": "888-464-1811",
            "fax_number": "800-416-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESILIENCE PSYCHOTHERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-06",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "CORI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "888-464-1811",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Lynn Remillard, FNP
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• Priscilla M. Renwick, NURSE PRACTITIONER
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• Melody Restivo, PT
• Restoration Counseling Services, LLC
• Restore Oculoplastics Gulf Coast

• All providers in Gulfport, MS
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.