Healthcare Provider Details

I. General information

NPI: 1821921057
Provider Name (Legal Business Name): GOOD HEART PROFESSIONAL COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

706 E PASS RD
GULFPORT MS
39507-3303
US

IV. Provider business mailing address

706 E PASS RD
GULFPORT MS
39507-3303
US

V. Phone/Fax

Practice location:
  • Phone: 228-731-2964
  • Fax: 228-731-2964
Mailing address:
  • Phone: 228-731-2964
  • Fax: 228-731-2964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KEMBERLI BROWN
Title or Position: OWNER/CLINICAL DIRECTOR
Credential: LCSW
Phone: 228-731-2964