Healthcare Provider Details

I. General information

NPI: 1871219626
Provider Name (Legal Business Name): BAILEY ANNE HEUSER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BAILEY BROWN

II. Dates (important events)

Enumeration Date: 10/13/2022
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13334 SEAWAY RD STE 213
GULFPORT MS
39503-5933
US

IV. Provider business mailing address

13334 SEAWAY RD STE 213
GULFPORT MS
39503-5933
US

V. Phone/Fax

Practice location:
  • Phone: 843-920-3605
  • Fax:
Mailing address:
  • Phone: 228-332-7689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3474
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: