Active NPI
Gail Kidd, LCDC
- Addiction (Substance Use Disorder) Counselor
- Lubbock, TX
National Provider Identifier
1487987111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 07502070
- Practice address
- 1614 Avenue K
Lubbock, TX 79401-5042 - Phone
- (806) 763-7633
- Fax
- (806) 765-0130
- NPI assigned
- Sep 14, 2009
- 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 | 07502070 | TX | Primary |
Addresses
Primary practice location
1614 Avenue K
Lubbock, TX 79401-5042
Mailing address
1614 Avenue K
Lubbock, TX 79401
Phone (806) 763-7633
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 065363601 | Medicaid | TX |
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 |
|---|---|---|---|
| 07502070 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1252886400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252886400000",
"number": "1487987111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1614 AVENUE K",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "79401",
"telephone_number": "806-763-7633",
"fax_number": "806-765-0130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1614 AVENUE K",
"city": "LUBBOCK",
"state": "TX",
"postal_code": "794015042",
"telephone_number": "806-763-7633",
"fax_number": "806-765-0130"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDD",
"first_name": "GAIL",
"name_prefix": "Mrs.",
"credential": "LCDC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-09-14",
"last_updated": "2009-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "07502070",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "065363601",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lubbock, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.