OrganizationActive
Gulf Coast Mental Health Center
NPI 1861715773 · Intellectual & Developmental Disabilities Psychologist · Gulfport, MS
Provider details
- NPI number
- 1861715773
- Entity type
- Organization
- Primary specialty
- Intellectual & Developmental Disabilities PsychologistBehavioral Health & Social Service Providers
- Parent organization
- Gulf Coast Mental Health Center
- Organization subpart
- Yes
- Authorized official
- Debora Stanovich, Credentials Specialist(228) 863-1132
- License
- R13-1 (MS)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Detailed profile(84/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1600 Broad Ave
Gulfport, MS 39501-3603
Phone: (228) 863-1132
Fax: (228) 865-1700
Street-level locationGet directions
Mailing address
1600 Broad Ave
Gulfport, MS 39501-3603
Other names (DBA / former)
- Other name
- Gulf Coast Industries
- Other name
- Gulf Coast Industries
Registry dates
- Enumerated
- 2010-03-05
- Last updated
- 2019-10-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.