Provider Demographics
NPI:1326201120
Name:GABODA, KAMAY H (LPC, LCAS)
Entity Type:Individual
Prefix:
First Name:KAMAY
Middle Name:H
Last Name:GABODA
Suffix:
Gender:F
Credentials:LPC, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 444
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-0444
Mailing Address - Country:US
Mailing Address - Phone:828-837-0071
Mailing Address - Fax:828-837-5309
Practice Address - Street 1:91 TIMBERLANE RD
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-7927
Practice Address - Country:US
Practice Address - Phone:828-454-7220
Practice Address - Fax:877-346-1089
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7003101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6103952Medicaid