Provider Demographics
NPI:1538503297
Name:GAINARD, JOANN E (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOANN
Middle Name:E
Last Name:GAINARD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 SHARPE ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:PA
Mailing Address - Zip Code:18704-2813
Mailing Address - Country:US
Mailing Address - Phone:570-288-7342
Mailing Address - Fax:
Practice Address - Street 1:106 SHARPE ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:PA
Practice Address - Zip Code:18704-2813
Practice Address - Country:US
Practice Address - Phone:570-288-7342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-24
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW129081104100000X
PACW0173691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker