Gulf Coast Children's Advocacy Center, Inc.

Primary specialty

Child Abuse Pediatrics PhysicianTaxonomy code 2080C0008X

Legal business name

GULF COAST CHILDREN'S ADVOCACY CENTER, INC.

Doing business as

Gulf Coast Sexual Assault Program

Practice address

210 East 11TH Street
Panama City, FL 32401

Phone

(850) 872-7760

NPI assigned

Sep 19, 2024

Last updated

Sep 19, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lori Marie Allen, MSPH

Title

Chief Executive Officer

Phone

(850) 872-7760

Specialties & licenses 4

Addresses

Other names 1

• Gulf Coast Sexual Assault Program Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Gulf Coast Children's Advocacy Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Gulf Coast Children's Advocacy Center Inc.

  • Voluntary or Charitable Agency
  • Panama City, FL
  • NPI 1861626236
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kandace Norris, RN

  • Registered Nurse
  • Panama City, FL
  • NPI 1053959718
  NPD
• Tasha Ann Jackson, LCSW

  • Mental Health Counselor
  • Panama City, FL
  • NPI 1851654248
  NPD (past)

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

{
    "created_epoch": "1726704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726704000000",
    "number": "1740017904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 EAST 11TH STREET",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "32401",
            "telephone_number": "850-872-7760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 EAST 11TH STREET",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "32401",
            "telephone_number": "850-872-7760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULF COAST CHILDREN'S ADVOCACY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-19",
        "last_updated": "2024-09-19",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "850-872-7760",
        "authorized_official_credential": "MSPH"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080C0008X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Child Abuse Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gulf Coast Sexual Assault Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Berlyn Guise, LCSW
• Gulf Coast Addiction Medicine
• Gulf Coast Anesthesia LLC
• Gulf Coast Autism Clinic, LLC
• Gulf Coast Children's Advocacy Center Inc.
• Gulf Coast Counseling Services of Bay County
• Gulf Coast Health Care Associates LLC (Sea Breeze Health Care)
• Gulf Coast Hearing Centers, Inc.
• Gulf Coast Hearing LLC (Gulf Coast Hearing Centers)
• Gulf Coast Heart and Vascular LLC

• Pediatrics Physician in Panama City, FL
• Providers in Panama City, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.