Individual
STACY GORMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, LPC-MH
Contact information
Practice address
2412 S CLIFF AVE, SUITE 200, SIOUX FALLS, SD 57105-4031
(605) 322-4079
(605) 322-4080
Mailing address
PO BOX 9191, MINNEAPOLIS, MN 55480-9191
(605) 322-6428
(605) 322-6499
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
06111289
SD
101YP2500X
Professional Counselor
Primary
LPC-MH2172
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6576790
—
SD
01
—
9287682
DAKOTACARE
—
Enumeration date
08/14/2007
Last updated
03/05/2010
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