Denitra L. Gaines, MA, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC009169 Issued in GA

Practice address

3114 Cherokee St NW
Suite 209
Kennesaw, GA 30144-6524

Phone

(770) 627-3550

Fax

(678) 401-8928

NPI assigned

Oct 12, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476230400000",
    "number": "1346790433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3114 CHEROKEE ST NW",
            "address_2": "SUITE 209",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446524",
            "telephone_number": "770-627-3550",
            "fax_number": "678-401-8928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3114 CHEROKEE ST NW",
            "address_2": "SUITE 209",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446524",
            "telephone_number": "770-627-3550",
            "fax_number": "678-401-8928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAINES",
        "first_name": "DENITRA",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-12",
        "last_updated": "2016-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC009169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Kennesaw, GA
• Providers in Kennesaw, GA by specialty
• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2016; 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.