Provider Demographics
NPI:1417491531
Name:GAINER, ARNISHA R (RBT)
Entity Type:Individual
Prefix:
First Name:ARNISHA
Middle Name:R
Last Name:GAINER
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4440 E PIKES PEAK AVE APT 325
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80916-5230
Mailing Address - Country:US
Mailing Address - Phone:719-465-3695
Mailing Address - Fax:719-465-3914
Practice Address - Street 1:2500 E 22ND ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-3204
Practice Address - Country:US
Practice Address - Phone:216-931-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-08
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COBACB505750106S00000X
OHS.12014241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1972553063OtherBUSINESS NPI
OH2098359Medicaid
OH367022Medicare UPIN