MEDICARE: MRS. LA-TOYA SHANNELLE GAINES PSY.D. L.P.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	6301015276	MI
2	103TC2200X	Clinical Child & Adolescent Psychologist	6301015276	MI

General Provider Information

NPI Number	:	1356678320
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LA-TOYA SHANNELLE GAINES PSY.D. L.P.

Provider Business Mailing Address
First Line	:	29532 SOUTHFIELD RD
Second Line	:	SUITE #101
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-2023
Country	:	US
Telephone Number	:	313-449-3913
Fax Number	:

Provider Business Practice Location Address
First Line	:	29532 SOUTHFIELD RD
Second Line	:	SUITE #101
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-2023
Country	:	US
Telephone Number	:	313-449-3913
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2009
Last Update Date	:	04/20/2016

Similar Medicare Providers

1639066178 — BRAIN BATH LLC
Practice Location Address:

29532 SOUTHFIELD RD STE 115
SOUTHFIELD, MI
48076-2023

Practice Phone: 989-690-1013
Practice Fax: 313-432-6019

1396694568 — EMILY LEMKE CLINICAL CARE & CONSULT P.L.L.C.
Practice Location Address:

29532 SOUTHFIELD RD STE 115
SOUTHFIELD, MI
48076-2023

Practice Phone: 248-229-8200
Practice Fax:

1194255307 — NOAH EDWARD FREIBURGER DNP, PMHNP-BC, CBIS
Practice Location Address:

29532 SOUTHFIELD RD STE 115
SOUTHFIELD, MI
48076-2023

Practice Phone: 989-465-5707
Practice Fax: 313-432-6019

1477736064 — EKONG COUNSELING CENTER
Practice Location Address:

29532 SOUTHFIELD RD , 101
SOUTHFIELD, MI
48076-2023

Practice Phone: 248-469-8322
Practice Fax: 248-423-4249

1649441957 — LYONS TRANSPORT INC.
Practice Location Address:

29532 SOUTHFIELD RD , 101
SOUTHFIELD, MI
48076-2023

Practice Phone: 248-559-5591
Practice Fax: 248-559-5771

1548553258 — LAFARRA HEMPHILL MSW, LMSW
Practice Location Address:

29532 SOUTHFIELD RD STE 115
SOUTHFIELD, MI
48076-2023

Practice Phone: 313-355-2846
Practice Fax: 812-554-5130

Directions to “ MRS. LA-TOYA SHANNELLE GAINES PSY.D. L.P.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.