Provider Demographics
NPI:1255427340
Name:RINEHART, GAIL ALLYN (MA LPC)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:ALLYN
Last Name:RINEHART
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3847 PINE GROVE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:FORT GRATIOT
Mailing Address - State:MI
Mailing Address - Zip Code:48059-4265
Mailing Address - Country:US
Mailing Address - Phone:586-354-8936
Mailing Address - Fax:206-350-4895
Practice Address - Street 1:3847 PINE GROVE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:FORT GRATIOT
Practice Address - State:MI
Practice Address - Zip Code:48059-4265
Practice Address - Country:US
Practice Address - Phone:586-354-8936
Practice Address - Fax:206-350-4895
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401002651101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional