Provider Demographics
NPI:1386148039
Name:GILL, KACY LYNN (MS, NCC, LPC)
Entity type:Individual
Prefix:
First Name:KACY
Middle Name:LYNN
Last Name:GILL
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:KACY
Other - Middle Name:LYNN
Other - Last Name:HUTCHINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:803 E DAKOTA AVE
Mailing Address - Street 2:
Mailing Address - City:PIERRE
Mailing Address - State:SD
Mailing Address - Zip Code:57501-3312
Mailing Address - Country:US
Mailing Address - Phone:605-224-5811
Mailing Address - Fax:605-224-6921
Practice Address - Street 1:803 E DAKOTA AVE
Practice Address - Street 2:
Practice Address - City:PIERRE
Practice Address - State:SD
Practice Address - Zip Code:57501-3312
Practice Address - Country:US
Practice Address - Phone:605-224-5811
Practice Address - Fax:605-224-6921
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC20222101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional