Provider Demographics
NPI:1700823168
Name:GAINEY, MAGGIE (PHD)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:GAINEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 E SAINT JOHN ST
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29302-1505
Mailing Address - Country:US
Mailing Address - Phone:864-356-0299
Mailing Address - Fax:
Practice Address - Street 1:391 SERPENTINE DR
Practice Address - Street 2:THE DOCTORS CENTER, SUITE 400
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3096
Practice Address - Country:US
Practice Address - Phone:864-560-7517
Practice Address - Fax:864-560-7520
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC885103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00792945OtherRAILROAD MEDICARE
NC6001167Medicaid
SCPS0464Medicaid
SCPS0464Medicaid
SCQ352117652Medicare PIN