Provider Demographics
NPI:1194545228
Name:GAINEY, SANDRA (BACHELORS)
Entity type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:
Last Name:GAINEY
Suffix:
Gender:F
Credentials:BACHELORS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 GUYTON CT
Mailing Address - Street 2:
Mailing Address - City:MULLINS
Mailing Address - State:SC
Mailing Address - Zip Code:29574-6014
Mailing Address - Country:US
Mailing Address - Phone:843-423-8292
Mailing Address - Fax:843-423-8294
Practice Address - Street 1:424 GUYTON CT
Practice Address - Street 2:
Practice Address - City:MULLINS
Practice Address - State:SC
Practice Address - Zip Code:29574-6014
Practice Address - Country:US
Practice Address - Phone:843-423-8292
Practice Address - Fax:843-423-9294
Is Sole Proprietor?:No
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)