Gorman, Stacy
Gorman, Stacy is an individual health care provider with primary practice located at 2412 S Cliff Ave Suite 200, Sioux Falls SD 57105-4031. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Gorman, Stacy can be contacted via phone (605) 322-4079.Contact Information
Primary practice address
2412 S Cliff Ave Suite 200
Sioux Falls SD 57105-4031
Phone: (605) 322-4079
Fax: (605) 322-4080
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 06111289 | South Dakota |
Behavioral Health & Social Service Providers / Professional | 101YP2500X | LPC-MH2172 | South Dakota |
Profile Details
NPI number | 1114119179 |
---|---|
LBN Legal business name | Gorman, Stacy |
Credentials | MS, LPC-MH |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Aug 14th, 2007 |
Last updated | Mar 5th, 2010 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1114119179 | NPPES |
South Dakota | MEDICAID | 6576790 | |
South Dakota | Other | 9287682 |
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