MR. DAVID CHARLES WILSON (NPI# 1417380783) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417380783 |
| Entity Type | Individual |
| Full Name | MR. DAVID CHARLES WILSON |
| Credential | LMFT |
| Practice Address |
1600 Broad Ave Gulfport MS 39501-3603 |
| Practice Telephone | 2288631132 |
| Practice Fax Number | 2288651700 |
| Mailing Telephone | 2288631132 |
| Mailing Fax Number | 2288651700 |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2013-08-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | T0472A | MS | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00018213 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760083828 | David Ephriam Wilson V | Pharmacist | 4099 Red Bluff Rd, Loris, SC 29569-6238 | 2020-11-05 |
| 1265030969 | David Nicholas Wilson | Social Worker | 2419 E Hazzard St, Philadelphia, PA 19125-3112 | 2020-10-14 |
| 1467059527 | David Ray Wilson IIi | Technician | 345 City Ave Apt 1, Beckley, WV 25801-5967 | 2020-10-02 |
| 1609484708 | David Wilson | Technician | 254 Township Road 1110, Proctorville, OH 45669-8437 | 2020-07-15 |
| 1598386856 | David Wilson | Pharmacist | 192 S Dry Creek Ln, Vineyard, UT 84059-5680 | 2020-04-28 |
| 1275982779 | David M. Wilson | Specialist/Technologist | 7510 Madison St, Merrillville, IN 46410-4609 | 2016-06-07 |
| 1609253376 | David Wilson Jr. | Massage Therapist | 2904 Odonnell St, Baltimore, MD 21224-4820 | 2015-05-01 |
| 1992115794 | David Andrew Wilson | Massage Therapist | 1501 E Jefferson St, Seattle, WA 98122-5627 | 2014-05-01 |
| 1184040800 | David Charles Wilson | Counselor | 116 Dumaine Pl, Madison, MS 39110-9234 | 2014-03-06 |
| 1104259167 | David Lawrence Wilson | Counselor | 702 E. Franklin Avenue, Sunnyside, WA 98944-0997 | 2013-08-14 |
| Street Address |
1600 BROAD AVE |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501-3603 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417934175 | Gulf Coast Mental Health Center | Psychologist | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2005-12-23 |
| 1043811839 | Kathy Ulland | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-11-06 |
| 1508463357 | Nicole Brown | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-10-05 |
| 1407453376 | Brian Weber | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-10-05 |
| 1457958639 | Krysten Vagedes | Registered Nurse | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-10-01 |
| 1184239436 | Yeinil Guzman | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-09-14 |
| 1972117216 | Nicole Hymel | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-09-03 |
| 1053921668 | Dana Alexis Mixon | Counselor | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-08-07 |
| 1801405964 | Elizabeth Moran | Peer Specialist | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-07-24 |
| 1013526177 | June Boudreaux | Peer Specialist | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2020-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301632 | Daniel Edward Bloom | Physician Assistant | Naval Branch Health Clinic Gulfport, 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2019-11-25 |
| 1730721374 | Affinity Healthcare LLC | Non-emergency Medical Transport (VAN) | 1822 15th St, Suite 8, Gulfport, MS 39501 | 2019-10-15 |
| 1093361156 | Gulf Coast Companion Care, LLC | Home Health | 1314 Pass Road, Ste B, Gulfport, MS 39501 | 2019-08-14 |
| 1609420991 | Greg Meekin Ent | Otolaryngology | 1201 31st Avenue, Gulfport, MS 39501 | 2019-07-25 |
| 1225681216 | Murphy Chiropractic Gulfport, LLC | Clinic/Center | 2700 25th Ave., Gulfport, MS 39501 | 2019-07-19 |
| 1477022838 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 1110 Broad Street, Suite 300, Gulfport, MS 39501 | 2018-11-15 |
| 1477003028 | Mindful Matters | Nurse Practitioner | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-06 |
| 1902294093 | Tangular Barnes | Nurse Practitioner | Gulf Coast Mental Health Center, 1600 Broad Ave, Gulfport, MS 39501 | 2014-12-25 |
| 1487065355 | Huong Nguyen | Pharmacist | 2433 25th Avenue, Gulfport, MS 39501 | 2014-05-14 |
| 1770907412 | Matthew Coleman | Military Health Care Provider | Nbhc Naval Construction Battalion Center Gulfport, 5501 Marvin Shields Blvd, Gulfport, MS 39501 | 2014-02-18 |
| Find all providers in zip 39501 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811559909 | Graystone Group LLC | Marriage & Family Therapist | 2218 18th St Ste B, Gulfport, MS 39501-2911 | 2019-06-28 |
| 1295200194 | Taylor South | Marriage & Family Therapist | 2802 Miriam St S, Gulfport, FL 33711-3720 | 2018-10-06 |
| 1831294313 | Dessie Elizabeth Faulkner | Marriage & Family Therapist | 12231 Ashley Dr, Suite C, Gulfport, MS 39503-2775 | 2006-09-13 |
| 1174579353 | Ray Collier | Marriage & Family Therapist | 12331a Ashley Dr, Gulfport, MS 39503-2738 | 2006-05-26 |
| 1053911586 | Dr. Michelle Jeanfreau LLC | Marriage & Family Therapist | 12337 Ashley Dr Ste C, Gulfport, MS 39503-2753 | 2020-10-26 |
| 1326692542 | Sonya Miller | Marriage & Family Therapist | 1600 Broad Ave, Gulfport, MS 39501-3603 | 2019-07-25 |
| 1609438977 | Graystone Group LLC | Marriage & Family Therapist | 2218 18th St Ste B, Gulfport, MS 39501-2911 | 2019-07-08 |
| 1649832999 | Benjamin Wood | Marriage & Family Therapist | 12337 Ashley Dr Ste C, Gulfport, MS 39503-2753 | 2019-07-07 |
| 1134578263 | Summer Lucas | Marriage & Family Therapist | 240b Courthouse Rd, Gulfport, MS 39507-1214 | 2016-06-09 |
| 1790082667 | Michelle Jeanfreau | Marriage & Family Therapist | 12337 Ashley Dr Ste C, Gulfport, MS 39503-2753 | 2011-02-11 |
| Find all providers in GULFPORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.