Provider Demographics
NPI:1831961762
Name:GULF COAST SOCIAL WORK LLC
Entity type:Organization
Organization Name:GULF COAST SOCIAL WORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:MELINDA
Authorized Official - Last Name:ZITTLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:228-326-7575
Mailing Address - Street 1:PO BOX 1703
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39566-1703
Mailing Address - Country:US
Mailing Address - Phone:228-278-5109
Mailing Address - Fax:866-364-0421
Practice Address - Street 1:4836 MAIN ST
Practice Address - Street 2:
Practice Address - City:MOSS POINT
Practice Address - State:MS
Practice Address - Zip Code:39563-2700
Practice Address - Country:US
Practice Address - Phone:228-278-5109
Practice Address - Fax:866-364-0421
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty