Gulfside Counseling and Wellness

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

GULFSIDE COUNSELING AND WELLNESS

Practice address

1101 Gulf Breeze PKW
BLDG 2, Ste 4
Gulf Breeze, FL 32561-4891

Phone

(850) 203-0045

NPI assigned

Apr 21, 2023

Organization subpart

No

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

Authorized official

Name

Stephanie S Peterson, LCSWNPI 1033672621

Title

Owner

Phone

(850) 261-3951

Specialties & licenses 1

Addresses

Other names 1

• Gulf Coast Counseling and Wellness Former legal business name

Medicare fee-for-service enrollment

Enrolled in FL

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.

• Stephanie Slorahn Peterson, LCSW

  • Clinical Social Worker
  • Gulf Breeze, FL
  • NPI 1033672621
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1831886514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 GULF BREEZE PKW",
            "address_2": "BLDG 2, STE 4",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614891",
            "telephone_number": "850-203-0045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 GULF BREEZE PKW",
            "address_2": "BLDG 2, STE 4",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325614891",
            "telephone_number": "850-203-0045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GULFSIDE COUNSELING AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-21",
        "last_updated": "2024-04-16",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "PETERSON",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-261-3951",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gulf Coast Counseling and Wellness",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Gulf Breeze Treatment Center (Gulf Breeze Recovery)
• Gulf Coast Family Medicine PLLC
• Gulf Coast Health System Imaging, LLC (Optimal Imaging Sacred Heart Health System)
• Gulf Coast Mobile Wound Care
• Gulf Coast Orthopedic Specialists
• Stephen A Gulsby, RPT
• Joshua Gilman Hackel, MD
• Katherine Laguens Haddock, ATC/L, OTC
• Tara Elizabeth Hagan
• Lauren Hagen, PA-C

• Clinical Social Worker in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.