Provider Demographics
NPI:1356417018
Name:PIERCE, GAYLE L (LPC CADC III)
Entity type:Individual
Prefix:MS
First Name:GAYLE
Middle Name:L
Last Name:PIERCE
Suffix:
Gender:F
Credentials:LPC CADC III
Other - Prefix:
Other - First Name:GAYLE
Other - Middle Name:
Other - Last Name:IRSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:N8459 FIR RD
Mailing Address - Street 2:
Mailing Address - City:PHILLIPS
Mailing Address - State:WI
Mailing Address - Zip Code:54555
Mailing Address - Country:US
Mailing Address - Phone:715-339-4592
Mailing Address - Fax:
Practice Address - Street 1:804 W 9TH ST N SUITE B
Practice Address - Street 2:AURORA COMMUNITY COUNSELING EMPLOYEE SUPPORT & SERVICES
Practice Address - City:LADYSMITH
Practice Address - State:WI
Practice Address - Zip Code:54848
Practice Address - Country:US
Practice Address - Phone:715-532-9771
Practice Address - Fax:715-532-9774
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1323125101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39751600Medicaid