Elena Maria Fairley, MS | |
11352 Mia Cir, Gulfport, MS 39503-3882 | |
(228) 265-0755 | |
Not Available |
Full Name | Elena Maria Fairley |
---|---|
Gender | Female |
Speciality | Counselor - Professional |
Location | 11352 Mia Cir, Gulfport, Mississippi |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1548471188 | NPI | - | NPPES |
00018214 | Medicaid | MS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | (* (Not Available)) | Secondary |
101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
Entity Name | Thrive Counseling Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1215181300 PECOS PAC ID: 0749458420 Enrollment ID: O20210415001555 |
Mailing Address | Practice Location Address |
---|---|
Elena Maria Fairley, MS 22052 Pine Haven Rd, Saucier, MS 39574-3882 Ph: (228) 346-0811 | Elena Maria Fairley, MS 11352 Mia Cir, Gulfport, MS 39503-3882 Ph: (228) 265-0755 |
Mrs. Brenda Kay Crew, LCSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 127 Gary St, Gulfport, MS 39503 Phone: 228-832-4495 Fax: 228-832-4495 | |
Mrs. Ashira Windsor, MSW, LCSW Counselor Medicare: Accepting Medicare Assignments Practice Location: 1601 30th Ave, Gulfport, MS 39501 Phone: 228-284-2644 Fax: 855-402-2013 | |
Krystal Rice, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1600 Broad Ave, Gulfport, MS 39501 Phone: 228-213-5888 Fax: 228-575-3433 | |
Christina Machelle Davis, P-LPC, M.S. Counselor Medicare: Not Enrolled in Medicare Practice Location: 2352 E Pass Rd, Gulfport, MS 39507 Phone: 228-284-2337 Fax: 228-284-2337 | |
Cynthia Willett, PCMHT Counselor Medicare: Not Enrolled in Medicare Practice Location: 1600 Broad Ave, Gulfport, MS 39501 Phone: 228-863-1132 | |
Ms. Rita A Rademacher, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 1600 Broad Ave, Gulfport, MS 39501 Phone: 228-863-1132 Fax: 228-865-1700 | |
Olivia Vepley, Counselor Medicare: Not Enrolled in Medicare Practice Location: 417 Security Sq, Gulfport, MS 39507 Phone: 363-222-8206 |