Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gavin David Kisebach

Individual provider Mental Health Counselor · NPI 1265210835

Gavin David Kisebach is a Mental Health Counselor in Lacey, Washington. Licensed in Washington. Registered with an NPI since 2023.

Licensed in
WA
In the registry since
2023

Practice location Address checks out

1034 Annette Ct SE
Lacey, WA 98503-1824
Phone: (360) 791-5826
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X (WA)

Record details

NPI number1265210835
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 15, 2023
Last updated in NPPESSeptember 15, 2023
Certification dateSeptember 15, 2023
Mailing address1034 Annette Ct Se, Lacey, WA 98503-1824

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