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NPI Code Detail

MEDICARE: NANCY ANN GAINES MS, LPC

MEDICARE: NANCY ANN GAINES MS, LPC
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
1101Y00000XCounselor189AK

General Provider Information

NPI Number : 1407031610
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANCY ANN GAINES MS, LPC
Provider Business Mailing Address
First Line : 4201 TUDOR CENTRE DR
Second Line : SUITE 320
City : ANCHORAGE
State : AK
Zip : 99508-5904
Country : US
Telephone Number : 907-729-6346
Fax Number : 907-729-6353
Provider Business Practice Location Address
First Line : 225 EAGLE ST
Second Line :
City : ANCHORAGE
State : AK
Zip : 99501-2626
Country : US
Telephone Number : 907-729-6346
Fax Number : 907-729-6353
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/07/2008
Last Update Date : 01/07/2008

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