Provider Demographics
NPI:1437817277
Name:GAINES, JOANNE M (MS)
Entity Type:Individual
Prefix:MS
First Name:JOANNE
Middle Name:M
Last Name:GAINES
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 PUSEY MILL RD
Mailing Address - Street 2:
Mailing Address - City:COCHRANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19330-1643
Mailing Address - Country:US
Mailing Address - Phone:610-405-1128
Mailing Address - Fax:
Practice Address - Street 1:101 W PARK PL
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:DE
Practice Address - Zip Code:19709-1324
Practice Address - Country:US
Practice Address - Phone:302-279-6491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional