Provider Demographics
NPI:1275331290
Name:KEARNS, GINA
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:KEARNS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:GEISER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:866 STABLEWATCH DR
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41051-8397
Mailing Address - Country:US
Mailing Address - Phone:859-445-3851
Mailing Address - Fax:
Practice Address - Street 1:3665 ERIE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45208-1982
Practice Address - Country:US
Practice Address - Phone:859-445-3851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2405704101YM0800X
KY297715101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health