Individual provider Active NPI

Racha Fares, PSY.D.

  • Clinical Neuropsychologist
  • Biloxi, MS
National Provider Identifier
1952727430
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
621130 Issued in MS
Practice address
1746 Pass Rd
Biloxi, MS 39531-3330
Phone
(284) 652-5242
Fax
(228) 248-0020
NPI assigned
Mar 8, 2014
Last updated
Apr 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PY 8944 FL
Clinical Neuropsychologist 103G00000X
Clinical Neuropsychologist 103G00000X 621130 MS Primary
Adult Development & Aging Psychologist 103TA0700X
Cognitive & Behavioral Psychologist 103TB0200X
Clinical Child & Adolescent Psychologist 103TC2200X

Addresses

Primary practice location

1746 Pass Rd
Biloxi, MS 39531-3330

Mailing address

1746 Pass Rd
Biloxi, MS 39531-3330
Phone (284) 652-5242

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220926002453 MS Practitioner - Clinical Psychologist 6103202346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

8837 Lorraine Rd
Suite B
Gulfport, MS 39503-5081
Phone (228) 246-2524

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY 8944FLMDClinical Neuropsychologist
621130MSMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Neuropsychology and Neuro-Rehabilitation Clinical Neuropsychologist CurrentSince Jul 1, 2022 Accepting new patients

Locations

8837 Lorraine Rd
Ste A1
Gulfport, MS 39503
Phone (228) 246-2524

8837 Lorraine Rd
Ste B
Gulfport, MS 39503
Phone (228) 246-2524

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1394236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1952727430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1746 PASS RD",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395313330",
            "telephone_number": "284-652-5242",
            "fax_number": "228-248-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1746 PASS RD",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395313330",
            "telephone_number": "284-652-5242",
            "fax_number": "228-248-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARES",
        "first_name": "RACHA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-08",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY 8944",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MS",
            "license": "621130",
            "primary": true
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Biloxi, MS

Sources for this page

Verify at the official NPI Registry.