Provider Demographics
NPI:1679915151
Name:DACY, KATE E (LPCC, LICDC)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:E
Last Name:DACY
Suffix:
Gender:F
Credentials:LPCC, LICDC
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:E
Other - Last Name:DACY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPCC, LICDC
Mailing Address - Street 1:1251 NILLES RD STE 5
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45014-7205
Mailing Address - Country:US
Mailing Address - Phone:513-939-0300
Mailing Address - Fax:513-939-0310
Practice Address - Street 1:1251 NILLES RD STE 5
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-7205
Practice Address - Country:US
Practice Address - Phone:513-939-0300
Practice Address - Fax:513-939-0310
Is Sole Proprietor?:No
Enumeration Date:2013-07-24
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLICDC.121079101YA0400X
OHE 0900676101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)