| Resilience Psychotherapy, Pllc | |
|
3427 Washington Ave Gulfport MS 39507-3039 | |
| (888) 464-1811 | |
| (800) 416-3070 |
| Full Name | Resilience Psychotherapy, Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 3427 Washington Ave, Gulfport, Mississippi |
| Authorized Official Name and Position | Cori L Walker (MANAGING MEMBER) |
| Authorized Official Contact | 8884641811 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Resilience Psychotherapy, Pllc 3427 Washington Ave Gulfport MS 39507-3039 Ph: (888) 464-1811 | Resilience Psychotherapy, Pllc 3427 Washington Ave Gulfport MS 39507-3039 Ph: (888) 464-1811 |
| NPI Number | 1720566201 |
|---|---|
| Provider Enumeration Date | 08/06/2018 |
| Last Update Date | 01/18/2022 |
| Certification Date | 01/18/2022 |
| Medicare PECOS PAC ID | 5991043515 |
|---|---|
| Medicare Enrollment ID | O20190206002000 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720566201 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Cori L Walker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851808893 PECOS PAC ID: 9234477852 Enrollment ID: I20190206002334 |
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