Provider Demographics
NPI:1255456315
Name:KIRK & GORDY ASSOCIATES, LLC
Entity type:Organization
Organization Name:KIRK & GORDY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:KIRK
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:641-856-2688
Mailing Address - Street 1:415 AND A HALF NORTH HAYNES
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52544
Mailing Address - Country:US
Mailing Address - Phone:641-856-2688
Mailing Address - Fax:641-856-2690
Practice Address - Street 1:415 AND A HALF NORTH HAYNES
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:IA
Practice Address - Zip Code:52544
Practice Address - Country:US
Practice Address - Phone:641-856-2688
Practice Address - Fax:641-856-2690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)