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General NPI Number Information
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NPI Number | 1902352263
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Entity Type | Individual
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Provider Name | ALDI GAINES LPC
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Gender | Female
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 06/29/2021
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Provider Practice Location Address
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Address Line | 104 WAXHAW PROFESSIONAL PARK DR STE D
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City | WAXHAW
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State | NC
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Zip | 28173-5020
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Country | US
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Telephone | 704-748-0735
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 470164
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City | CHARLOTTE
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State | NC
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Zip | 28247-0164
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Country | US
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Telephone | 704-672-4655
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6446
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 12388
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License Number State | NC
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