Provider Demographics
NPI:1437161569
Name:KANE, GINA (MA, NCC, LMHC)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:KANE
Suffix:
Gender:F
Credentials:MA, NCC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 IMMOKALEE RD
Mailing Address - Street 2:216
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1421
Mailing Address - Country:US
Mailing Address - Phone:239-273-7587
Mailing Address - Fax:239-596-8901
Practice Address - Street 1:2180 IMMOKALEE RD
Practice Address - Street 2:216
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1421
Practice Address - Country:US
Practice Address - Phone:239-273-7587
Practice Address - Fax:239-596-8901
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH0004973101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health