PEBBLES M KING (NPI# 1619067345) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619067345 |
| Entity Type | Individual |
| Full Name | PEBBLES M KING |
| Credential | BS |
| Practice Address |
3407 Shamrock Court Gautier MS 39553 |
| Practice Telephone | 2284970690 |
| Practice Fax Number | 2284971363 |
| Mailing Telephone | 2284970690 |
| Mailing Fax Number | 2284971363 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00018214 | 05 |
| Street Address |
3407 SHAMROCK COURT |
| City | GAUTIER |
| State | MS |
| Zip Code | 39553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326142076 | Rose Marie Morton | Social Worker | 3407 Shamrock Court, Gautier, MS 39553 | 2006-09-12 |
| 1417312067 | Evencia Fox | Case Manager/Care Coordinator | 3407 Shamrock Court, Gautier, MS 39553 | 2015-12-28 |
| 1508221151 | Constance S Rhodes Warren | Case Manager/Care Coordinator | 3407 Shamrock Court, Gautier, MS 39553 | 2015-12-28 |
| 1568545804 | Janet Patrick Stoudenmire | Counselor | 3407 Shamrock Court, Gautier, MS 39553 | 2006-10-23 |
| 1205916525 | Michelle C Colella | Counselor | 3407 Shamrock Court, Gautier, MS 39553 | 2006-10-17 |
| 1780774489 | Gwendolyn M Chapman | Counselor | 3407 Shamrock Court, Gautier, MS 39553 | 2006-10-13 |
| 1093805707 | Dianne Aultman | Counselor | 3407 Shamrock Court, Gautier, MS 39553 | 2006-10-13 |
| 1902996614 | Michael J Lewis | Counselor | 3407 Shamrock Court, Gautier, MS 39553 | 2006-10-13 |
| 1639269475 | Richard E Durr | Counselor | 3407 Shamrock Court, Gautier, MS 39553 | 2006-10-13 |
| 1366532129 | Suzanne Katz | Registered Nurse | 3407 Shamrock Court, Gautier, MS 39553 | 2006-10-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205465044 | Loggan Malone | Dentist | 2808 Us-90 W, Gautier, MS 39553 | 2020-04-03 |
| 1770979775 | Catherine Durham | Counselor | 3407 Shamrock Dr., Gautier, MS 39553 | 2015-04-07 |
| 1851648836 | Pharmatex, LLC | Pharmacy | 4551-d Gautier Vancleave Road, Gautier, MS 39553 | 2012-08-09 |
| 1891957544 | David W Bonderer Dds Pllc | Dentist | 2808 Hwy 90, Suite 1, Gautier, MS 39553 | 2008-06-25 |
| 1790830313 | William D Parrish | Dentist | 713 Us Hwy 90, Gautier, MS 39553 | 2007-01-24 |
| 1073685830 | Jeffrey Lamone Knight | Dentist | 3105 Shaw Dr., Gautier, MS 39553 | 2006-11-15 |
| 1720178437 | Erica B Wilson | Counselor | 3704 Shamrock Court, Gautier, MS 39553 | 2006-10-13 |
| 1881781631 | James D Victory | Chiropractor | 315 Highway 90, Gautier, MS 39553 | 2006-10-05 |
| 1508959180 | Robert Douglas Holbert | Internal Medicine | 2105 Old Spanish Trail, Gautier, MS 39553 | 2006-10-02 |
| 1962508119 | Sentry-gautier, Inc. | Nursing Facility/Intermediate Care Facility | 5090 Gautier Vancleave Road, Gautier, MS 39553 | 2006-09-15 |
| Find all providers in zip 39553 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023662822 | Debra Ann Dionne | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2019-07-30 |
| 1306315726 | Jacqueline Gail Pharr | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2018-11-14 |
| 1972055408 | Crystal Cox | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2016-11-01 |
| 1548647365 | Lori Howell | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2015-04-30 |
| 1902298227 | Sage M Moye | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2015-02-24 |
| 1356783237 | Sarah Marie Pradillo | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2013-07-22 |
| 1558704411 | Annie Williams | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2013-04-10 |
| 1194168302 | Robert L Smith | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-5337 | 2013-04-08 |
| 1629338579 | Amy H. Turner | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-6429 | 2012-05-25 |
| 1407135213 | Barbara Teresa Evans | Counselor | 3407 Shamrock Ct, Gautier, MS 39553-6429 | 2011-08-10 |
| Find all providers in GAUTIER | ||||
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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.