Active NPI
Susan B Gaines, LCDC
- Addiction (Substance Use Disorder) Counselor
- Kodiak, AK
National Provider Identifier
1487106605
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 2427
- Practice address
- 3449 Rezanof Drive East
Kodiak, AK 99615 - Phone
- (907) 486-9800
- Fax
- (907) 486-9896
- NPI assigned
- Nov 4, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 2427 | TX | Primary |
Addresses
Primary practice location
3449 Rezanof Drive East
Kodiak, AK 99615
Mailing address
3449 Rezanof Drive East
Kodiak, AK 99615
Phone (907) 486-9800
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2427 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478217600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478217600000",
"number": "1487106605",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3449 REZANOF DRIVE EAST",
"city": "KODIAK",
"state": "AK",
"postal_code": "99615",
"telephone_number": "907-486-9800",
"fax_number": "907-486-9896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3449 REZANOF DRIVE EAST",
"city": "KODIAK",
"state": "AK",
"postal_code": "99615",
"telephone_number": "907-486-9800",
"fax_number": "907-486-9896"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAINES",
"first_name": "SUSAN",
"middle_name": "B",
"credential": "LCDC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-04",
"last_updated": "2016-11-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "2427",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kodiak, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.