Provider Demographics
NPI:1346749603
Name:GAINER, ELIZABETH K (LMHC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:K
Last Name:GAINER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3948 3RD ST S # 246
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32250-5847
Mailing Address - Country:US
Mailing Address - Phone:904-568-2865
Mailing Address - Fax:
Practice Address - Street 1:2380 3RD ST S STE 2
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-8038
Practice Address - Country:US
Practice Address - Phone:904-568-2865
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-01
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH20707101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health