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General NPI Number Information
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NPI Number | 1891597647
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Entity Type | Organization
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Legal Business Name | GAINES INSIGHT COUNSELING LLC
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Dates
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Enumeration Date | 03/25/2025
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 26700 LAHSER RD
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City | SOUTHFIELD
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State | MI
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Zip | 48033-2608
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Country | US
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Telephone | 313-915-0672
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 315
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City | SOUTHFIELD
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State | MI
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Zip | 48037-0315
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Country | US
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Telephone | 313-915-0672
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | ANETRA M GAINES
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Credential | MA,LPC,CRC,CAADC-D
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Telephone | 313-915-0672
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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