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General NPI Number Information
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NPI Number | 1295072338
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Entity Type | Individual
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Provider Name | AMY GAINES LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/09/2013
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Last Update Date | 07/11/2025
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Provider Practice Location Address
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Address Line | 225 E MINNESOTA ST
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City | BROOKHAVEN
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State | MS
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Zip | 39601-3833
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Country | US
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Telephone | 601-937-2041
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Fax | 855-845-7341
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Provider Business Mailing Address
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Address Line | 253 PINE VIEW CIR
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City | FLORA
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State | MS
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Zip | 39071-9608
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Country | US
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Telephone | 601-937-2041
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Fax | 855-845-7341
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C7464
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License Number State | MS
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