| Resonance Professional Counseling | |
|
368 Courthouse Rd Ste D Gulfport MS 39507-1854 | |
| (228) 341-1079 | |
| Not Available |
| Full Name | Resonance Professional Counseling |
|---|---|
| Speciality | Counselor |
| Location | 368 Courthouse Rd Ste D, Gulfport, Mississippi |
| Authorized Official Name and Position | Kristine D Wilson (OWNER) |
| Authorized Official Contact | 2283411079 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Resonance Professional Counseling 15256 Three Rivers Rd Biloxi MS 39532-8066 Ph: (228) 341-1079 | Resonance Professional Counseling 368 Courthouse Rd Ste D Gulfport MS 39507-1854 Ph: (228) 341-1079 |
| NPI Number | 1326605601 |
|---|---|
| Provider Enumeration Date | 05/22/2019 |
| Last Update Date | 09/26/2024 |
| Certification Date | 09/26/2024 |
| Medicare PECOS PAC ID | 9234660390 |
|---|---|
| Medicare Enrollment ID | O20241001001818 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326605601 | NPI | - | NPPES |
| 05278341 | Medicaid | MS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Kristine D Wilson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346775863 PECOS PAC ID: 1052842119 Enrollment ID: I20241001002064 |
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