Individual provider · Type 1 NPI

Vivian Keller Tate, LCSW

Clinical Social Worker · Gulfport, MS

NPI number 1063531663 Active

Practice location

1403 43rd Avenue
Gulfport, MS 39501

Call (228) 897-7730 Map

Fax (228) 575-0886

Mailing address

P.o. Box 7827
Gulfport, MS 39506

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker 1041C0700X2561 (MS)
Clinical Social Worker Primary 1041C0700XC2058 (MS)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1063531663

Vivian Keller Tate, LCSW's National Provider Identifier is 1063531663, issued on Mar 28, 2007. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Gulfport, MS. The record was last updated on Sep 22, 2010.