Provider Demographics
NPI:1598526501
Name:GAINES, PATRICIA BROWN (LCSW-C)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:BROWN
Last Name:GAINES
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24077 COUNTRY LIVING RD
Mailing Address - Street 2:
Mailing Address - City:MILLSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19966-3188
Mailing Address - Country:US
Mailing Address - Phone:302-224-1400
Mailing Address - Fax:
Practice Address - Street 1:24077 COUNTRY LIVING RD
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-3188
Practice Address - Country:US
Practice Address - Phone:302-224-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00010351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical