| Singing River Services | |
|
3407 Shamrock Ct Gautier MS 39553 | |
| (228) 497-0690 | |
| (228) 497-1363 |
| Full Name | Singing River Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 3407 Shamrock Ct, Gautier, Mississippi |
| Authorized Official Name and Position | Sherman F Blackwell (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2284970690 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Singing River Services 3407 Shamrock Ct Gautier MS 39553 Ph: (228) 497-0690 | Singing River Services 3407 Shamrock Ct Gautier MS 39553 Ph: (228) 497-0690 |
| NPI Number | 1851407829 |
|---|---|
| Provider Enumeration Date | 08/22/2006 |
| Last Update Date | 05/10/2010 |
| Medicare PECOS PAC ID | 2466547104 |
|---|---|
| Medicare Enrollment ID | O20070926000953 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851407829 | NPI | - | NPPES |
| 00770256 | Medicaid | MS | |
| 00018214 | Medicaid | MS |
| Provider Name | Gregory B Fox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427230713 PECOS PAC ID: 4981611480 Enrollment ID: I20060308000336 |
| Provider Name | Julie T Trice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184626905 PECOS PAC ID: 7113968397 Enrollment ID: I20070927000274 |
| Provider Name | George V Davis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700041308 PECOS PAC ID: 5395812895 Enrollment ID: I20080925000322 |
| Provider Name | Angelos Vamvakas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538199831 PECOS PAC ID: 0143452250 Enrollment ID: I20140403001550 |
| Provider Name | Tangular Michelle Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902294093 PECOS PAC ID: 9335459122 Enrollment ID: I20151106001037 |
| Provider Name | Lacondra J Malcom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487012043 PECOS PAC ID: 2961783931 Enrollment ID: I20170105001561 |
| Provider Name | Ramona Rachel Girley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437648854 PECOS PAC ID: 8527323849 Enrollment ID: I20180607000277 |
| Provider Name | Zetonnia Milburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649852609 PECOS PAC ID: 3375942865 Enrollment ID: I20210603002285 |
Singing River Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3407 Shamrock Ct, Gautier, MS 39553 Phone: 228-497-0690 Fax: 228-497-1363 | |
Donna M Lewis Lcsw Pllc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1713 Old Spanish Trl, Gautier, MS 39553 Phone: 228-218-9825 Fax: 228-282-8578 | |
Dreamtree Enterprises, L.l.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1408 Highway 90 Ste 6, Gautier, MS 39553 Phone: 228-205-2918 Fax: 228-205-2918 | |
Singing River Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3407 Shamrock Ct, Gautier, MS 39553 Phone: 228-497-0690 Fax: 228-497-7604 | |
Ellen L Malone Sole Mbr Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1408 Highway 90, Suite 2, Gautier, MS 39553 Phone: 228-497-8180 Fax: 228-497-6594 |