Provider Demographics
NPI:1508992306
Name:PALCHIKOFF, GAIL KARON (MFT)
Entity Type:Individual
Prefix:MS
First Name:GAIL
Middle Name:KARON
Last Name:PALCHIKOFF
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12400 CREEK CREST DR
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-7727
Mailing Address - Country:US
Mailing Address - Phone:775-851-4814
Mailing Address - Fax:775-851-4874
Practice Address - Street 1:137 VASSAR ST # B
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-2814
Practice Address - Country:US
Practice Address - Phone:775-722-0549
Practice Address - Fax:775-851-4874
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0715101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100507909Medicaid
NE100507910Medicaid