Dessie Elizabeth Faulkner, LMFT

Individual provider Active NPI Marriage & Family Therapist · Gulfport, MS

NPI 1831294313 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1831294313
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
T0329 (MS)
Practice address
12231 Ashley Dr
Suite C
Gulfport, MS 39503-2775
Phone
(228) 831-9400
Fax
(228) 831-9600
NPI assigned
Sep 13, 2006
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)
Yes

State licenses

LicenseStateTypeSpecialty
T0329MSMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Awakenings, PA Past Accepting new patients
Brightside Medical, P.C. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X T0329 MS Yes

Addresses

Primary practice location

12231 Ashley Dr
Suite C
Gulfport, MS 39503-2775

Mailing address

12231 Ashley Dr
Suite C
Gulfport, MS 39503-2775
Phone (228) 831-9400

Other providers in Gulfport, MS

All providers in Gulfport, MS · Marriage & Family Therapist in Mississippi

Sources for this page

Verify at the official NPI Registry.