Provider Demographics
NPI:1770959991
Name:GAPP, DEBRA KAY (LPC-MH, LAC, QMHP)
Entity type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:KAY
Last Name:GAPP
Suffix:
Gender:F
Credentials:LPC-MH, LAC, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 553
Mailing Address - Street 2:GAPP COUNSELING SERVICES
Mailing Address - City:VERMILLION
Mailing Address - State:SD
Mailing Address - Zip Code:57069
Mailing Address - Country:US
Mailing Address - Phone:605-677-9052
Mailing Address - Fax:
Practice Address - Street 1:1120 VALLEY VIEW DR.
Practice Address - Street 2:GAPP COUNSELING SERVICES
Practice Address - City:VERMILLION
Practice Address - State:SD
Practice Address - Zip Code:57069
Practice Address - Country:US
Practice Address - Phone:605-677-9052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-12
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH2195101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD6576840Medicaid