Danae Doyle

Individual provider Active NPI Clinical Social Worker · Gulfport, MS

NPI 1750267142 · NPPES record last updated Aug 12, 2025

Key facts

NPI
1750267142
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
C11308 (MS)
Practice address
2715 Bullis Ave
Gulfport, MS 39501-5233
Phone
(228) 220-4226
NPI assigned
Aug 12, 2025
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
C11308MSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Professional Counseling Services, LLC Clinical Current
since Aug 17, 2025
Accepting new patients
Kimila Deflanders LCSW LLC Clinical Past
since Aug 17, 2025
Accepting new patients

Locations

2715 Bullis Ave
Gulfport, MS 39501
Phone (228) 220-4226

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C11308 MS Yes

Addresses

Primary practice location

2715 Bullis Ave
Gulfport, MS 39501-5233

Mailing address

11150 Highway 49
Gulfport, MS 39503-4110
Phone (228) 305-0126

Other providers in Gulfport, MS

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

Sources for this page

Verify at the official NPI Registry.