Provider Demographics
NPI:1679522890
Name:GAINES, ROSALIND E (LCSW)
Entity type:Individual
Prefix:MS
First Name:ROSALIND
Middle Name:E
Last Name:GAINES
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 1:14460 STRATHMORE LANE
Mailing Address - Street 2:#302
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33446-3028
Mailing Address - Country:US
Mailing Address - Phone:954-295-0369
Mailing Address - Fax:561-684-8582
Practice Address - Street 1:14460 STRATHMORE LANE
Practice Address - Street 2:#302
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33446-3028
Practice Address - Country:US
Practice Address - Phone:954-295-0369
Practice Address - Fax:866-757-5778
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-06
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW35161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ6481ZMedicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER