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General NPI Number Information
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NPI Number | 1881217545
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Entity Type | Individual
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Provider Name | DANIEL LAURENCE GAINER CDCA
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Gender | Male
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Dates
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Enumeration Date | 05/28/2020
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 2115 W PARK DR
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City | LORAIN
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State | OH
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Zip | 44053-1138
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Country | US
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Telephone | 440-989-4900
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Fax | 440-282-4779
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Provider Business Mailing Address
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Address Line | 12126 E RIVER RD
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City | COLUMBIA STATION
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State | OH
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Zip | 44028-9534
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Country | US
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Telephone | 440-281-3081
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Fax |
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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 | S.2411551
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCDCII.162023
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License Number State | OH
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