Provider Demographics
NPI:1093553562
Name:GOLEY, KAYCE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KAYCE
Middle Name:
Last Name:GOLEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13892 N HONEY CREEK LN E
Mailing Address - Street 2:
Mailing Address - City:CAMBY
Mailing Address - State:IN
Mailing Address - Zip Code:46113-8766
Mailing Address - Country:US
Mailing Address - Phone:317-600-7491
Mailing Address - Fax:
Practice Address - Street 1:13892 N HONEY CREEK LN E
Practice Address - Street 2:
Practice Address - City:CAMBY
Practice Address - State:IN
Practice Address - Zip Code:46113-8766
Practice Address - Country:US
Practice Address - Phone:317-600-7491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-18
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN3401038A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical