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GAVIN DAVID KISEBACH
NPI 1265210835
Counselor - Mental Health in Lacey, WA

Active since September 15, 2023
1034 ANNETTE CT SE, LACEY, WA 98503(360) 791-5826 Get Directions Write a Review

NPPES record last updated: September 15, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Gavin David Kisebach NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GAVIN DAVID KISEBACH (NPI 1265210835) is an individual mental health provider in Lacey, Washington and active in the NPI registry since September 2023.

NPPES Registry Identity

NPI1265210835
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameGAVIN DAVID KISEBACH
Location Address1034 ANNETTE CT SELacey, WA 98503-1824
Mailing Address1034 Annette Ct SeLacey, WA 98503-1824 · (360) 791-5826
Phone(360) 791-5826
Sole ProprietorNo
Enumeration DateSeptember 15, 2023
NPPES CertifiedSeptember 15, 2023
✔ NPI 1265210835 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
1034 ANNETTE CT SE, Lacey, WA 98503
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gavin Kisebach's NPI number?

The NPI number for Gavin Kisebach is 1265210835. It was assigned to this individual provider in the NPPES registry on September 15, 2023.

Where is Gavin Kisebach located?

Gavin Kisebach practices at 1034 Annette Ct SE, Lacey, WA 98503. The listed phone number is (360) 791-5826.

What is Gavin Kisebach's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Gavin Kisebach was last updated on September 15, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.