Provider Demographics
NPI:1952420135
Name:FLANAGAN, KACY SUZANNE (LPC)
Entity type:Individual
Prefix:MS
First Name:KACY
Middle Name:SUZANNE
Last Name:FLANAGAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 146
Mailing Address - Street 2:
Mailing Address - City:SULPHUR SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:75483-0146
Mailing Address - Country:US
Mailing Address - Phone:903-461-2183
Mailing Address - Fax:903-885-3613
Practice Address - Street 1:2121 MAIN ST
Practice Address - Street 2:
Practice Address - City:SULPHUR SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:75482
Practice Address - Country:US
Practice Address - Phone:903-461-2183
Practice Address - Fax:903-885-3613
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19255101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7539LCOtherBLUE CROSS BLUE SHIELD