NPIMap

Organization Active NPI

Graceful Pathways Inc

  • Clinical Social Worker
  • Gulfport, MS
National Provider Identifier
1912624495
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
GRACEFUL PATHWAYS INC
Practice address
11530 US 49
Suite E
Gulfport, MS 39503-3950
Phone
(228) 707-2007
NPI assigned
Oct 25, 2022
Last updated
Oct 2, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Authorized official

Name
Jodi Renee Klubnik, LCSWNPI 1952776684
Title
Owner/Director
Phone
(228) 669-4367

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Mental Health Clinic/Center 261QM0850X NU
Adolescent and Children Mental Health Clinic/Center 261QM0855X NU
Clinical Social Worker 1041C0700X NU Primary
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

11530 US 49
Suite E
Gulfport, MS 39503-3950

Mailing address

4509 Jefferson Ave
Gulfport, MS 39507-4022
Phone (228) 669-4367

Other practice location 1

1643 E Pass Rd Ste B
Gulfport, MS 39507-3505
Phone (228) 707-2007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221213003344 MS Part B Supplier - Clinic/Group Practice 7719356773 Receives reassigned benefits from 1 practitioner
Practice locations: Gulfport, MS

National Provider Directory

National Provider Directory

Locations

11530 Highway 49
Ste E
Gulfport, MS 39503
Phone (228) 707-2007

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1666656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790899200000",
    "number": "1912624495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4509 JEFFERSON AVE",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395074022",
            "telephone_number": "228-669-4367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11530 US 49",
            "address_2": "SUITE E",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395033950",
            "telephone_number": "228-707-2007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1643 E Pass Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Gulfport",
            "state": "MS",
            "postal_code": "395073505",
            "country_code": "US",
            "telephone_number": "228-707-2007",
            "fax_number": "228-707-4119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRACEFUL PATHWAYS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-25",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A",
        "authorized_official_last_name": "KLUBNIK",
        "authorized_official_first_name": "JODI",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "228-669-4367",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; 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.