Organization
STACY GORMAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACY GORMAN MS, LPC-MH, CCDCIII (COUNSELOR/OWNER)
(605) 940-6422
Entity
Organization
Contact information
Practice address
2121 W 63RD PL STE 100, SIOUX FALLS, SD 57108-5060
(605) 940-6422
Mailing address
2121 W 63RD PL STE 100, SIOUX FALLS, SD 57108-5060
(605) 940-6422
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114119179
NPI
SD
Enumeration date
02/28/2013
Last updated
02/28/2013
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