| Gulf Coast Social Work Llc | |
|
4836 Main St Moss Point MS 39563-2700 | |
| (228) 278-5109 | |
| (866) 364-0421 |
| Full Name | Gulf Coast Social Work Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4836 Main St, Moss Point, Mississippi |
| Authorized Official Name and Position | Karen Melinda Zittleman (PRESIDENT) |
| Authorized Official Contact | 2283267575 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gulf Coast Social Work Llc Po Box 1703 Ocean Springs MS 39566-1703 Ph: (228) 278-5109 | Gulf Coast Social Work Llc 4836 Main St Moss Point MS 39563-2700 Ph: (228) 278-5109 |
| NPI Number | 1831961762 |
|---|---|
| Provider Enumeration Date | 10/24/2023 |
| Last Update Date | 04/11/2025 |
| Certification Date | 04/11/2025 |
| Medicare PECOS PAC ID | 6002262250 |
|---|---|
| Medicare Enrollment ID | O20231025001376 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831961762 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | (* (Not Available)) | Primary |
| Provider Name | Karen O Zittleman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063779734 PECOS PAC ID: 2062675143 Enrollment ID: I20120530000375 |
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