Active NPI
Kandice Laray Gorres, LADC
- Addiction (Substance Use Disorder) Counselor
- Alexandria, MN
National Provider Identifier
1306305339
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 303756
- Practice address
- 222 9TH Ave W
Alexandria, MN 56308-2221 - Phone
- (320) 763-3912
- Fax
- (320) 763-6629
- NPI assigned
- Mar 19, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 303756 | MN | Primary |
Addresses
Primary practice location
222 9TH Ave W
Alexandria, MN 56308-2221
Mailing address
222 9TH Ave W
Alexandria, MN 56308-2221
Phone (320) 763-3912
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 303756 | MN | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1552953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1552953600000",
"number": "1306305339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "222 9TH AVE W",
"city": "ALEXANDRIA",
"state": "MN",
"postal_code": "563082221",
"telephone_number": "320-763-3912",
"fax_number": "320-763-6629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "222 9TH AVE W",
"city": "ALEXANDRIA",
"state": "MN",
"postal_code": "563082221",
"telephone_number": "320-763-3912",
"fax_number": "320-763-6629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORRES",
"first_name": "KANDICE",
"middle_name": "LARAY",
"credential": "LADC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-19",
"last_updated": "2019-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MN",
"license": "303756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Alexandria, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.