Provider Demographics
NPI:1316798333
Name:GINGERICH, KAYCEE ANN (LBSW)
Entity type:Individual
Prefix:
First Name:KAYCEE
Middle Name:ANN
Last Name:GINGERICH
Suffix:
Gender:F
Credentials:LBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 2ND ST SE STE 2
Mailing Address - Street 2:
Mailing Address - City:RUGBY
Mailing Address - State:ND
Mailing Address - Zip Code:58368-1830
Mailing Address - Country:US
Mailing Address - Phone:701-871-2409
Mailing Address - Fax:701-776-2516
Practice Address - Street 1:240 2ND ST SE STE 2
Practice Address - Street 2:
Practice Address - City:RUGBY
Practice Address - State:ND
Practice Address - Zip Code:58368-1830
Practice Address - Country:US
Practice Address - Phone:701-871-2409
Practice Address - Fax:701-776-2516
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND6019171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator