Individual provider Active NPI

Jalayna Dickerson Gaines, LCSW

  • Clinical Social Worker
  • Arlington, TX
National Provider Identifier
1053072264
Registry record updated Sep 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
57912 Issued in TX
Practice address
2000 E. Lamar Blvd.
Ste. 600 PMB #129
Arlington, TX 76006
Phone
(817) 286-5951
NPI assigned
Jan 10, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 57912 TX Primary

Addresses

Primary practice location

2000 E. Lamar Blvd.
Ste. 600 PMB #129
Arlington, TX 76006

Mailing address

2000 E. Lamar Blvd.
Ste. 600 PMB #129
Arlington, TX 76006
Phone (817) 286-5951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
57912TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Gaines Counseling, PLLC Clinical Current Accepting new patients
Studio 4-1-1 Counseling & Consulting, PLLC Clinical PastSince Jan 1, 2022 Accepting new patients

Locations

2000 E Lamar Blvd
Ste 600
Arlington, TX 76006
Phone (214) 519-9473

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664236800000",
    "number": "1053072264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 E. LAMAR BLVD.",
            "address_2": "STE. 600 PMB #129",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "76006",
            "telephone_number": "817-286-5951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 E. LAMAR BLVD.",
            "address_2": "STE. 600 PMB #129",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "76006",
            "telephone_number": "817-286-5951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAINES",
        "first_name": "JALAYNA",
        "middle_name": "DICKERSON",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-09-27",
        "certification_date": "2022-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "57912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.