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General NPI Number Information
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NPI Number | 1851196455
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Entity Type | Organization
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Legal Business Name | STABLE GAINS MENTAL HEALTH SERVICE LLC
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Dates
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Enumeration Date | 02/17/2025
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Last Update Date | 02/10/2026
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Provider Practice Location Address
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Address Line | 304 N WALNUT ST RM 9
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City | PLYMOUTH
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State | IN
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Zip | 46563-1787
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Country | US
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Telephone | 574-701-2355
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 404
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City | PLYMOUTH
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State | IN
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Zip | 46563-0404
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Country | US
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Telephone | 574-701-2355
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Fax |
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Authorized Official
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Title or Position | OWNER / MEMBER MANAGER
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Name | MRS. JODIE KAY GAINES
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Credential | LCSW, LCAC
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Telephone | 574-701-2355
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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 |
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License Number State |
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