Organization
MAGNOLIA TIDES COUNSELING AND CONSULTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVE G SELF LPC-S (OWNER, THERAPIST)
(601) 436-9514
Entity
Organization
Contact information
Practice address
2124 GOVERNMENT ST, OCEAN SPRINGS, MS 39564-3937
(601) 436-9514
Mailing address
5390 OVERLAND DR, BILOXI, MS 39532-8590
(601) 436-9514
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1487337317
NPI 1
MS
01
—
2748
LPC
MS
Enumeration date
07/23/2025
Last updated
09/18/2025
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