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:
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Health care specialties

SpecialtyCodeLicense #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 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114119179 NPPES
South Dakota MEDICAID 6576790
South Dakota Other 9287682

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