Provider Demographics
NPI:1740517747
Name:GAINER, JANE ELIZABETH (LPCC)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:ELIZABETH
Last Name:GAINER
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:JANE
Other - Middle Name:ELIZABETH
Other - Last Name:BLANKENSHIP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4305 WOODED BEND WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-8408
Mailing Address - Country:US
Mailing Address - Phone:502-243-4298
Mailing Address - Fax:502-489-5552
Practice Address - Street 1:13113 EASTPOINT PARK BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-4191
Practice Address - Country:US
Practice Address - Phone:502-489-5550
Practice Address - Fax:502-489-5552
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-11
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0640101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional