Provider Demographics
NPI:1891426458
Name:GULF COAST COUNSELING
Entity Type:Organization
Organization Name:GULF COAST COUNSELING
Other - Org Name:GULF COAST COUNSELING LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:ELISE
Authorized Official - Last Name:LOVELACE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, LMFT
Authorized Official - Phone:850-380-9841
Mailing Address - Street 1:920 W GOVERNMENT ST
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32502-5308
Mailing Address - Country:US
Mailing Address - Phone:850-807-0114
Mailing Address - Fax:
Practice Address - Street 1:920 W GOVERNMENT ST
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32502-5308
Practice Address - Country:US
Practice Address - Phone:508-078-0114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-23
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1770803140Medicaid
LA1366007536Medicaid