Provider Demographics
NPI:1174991020
Name:GAINER, JULIE STOKES (LCAS)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:STOKES
Last Name:GAINER
Suffix:
Gender:F
Credentials:LCAS
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:NEWMAN
Other - Last Name:GAINER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:855 CRESCENT RD
Mailing Address - Street 2:
Mailing Address - City:ROCKWELL
Mailing Address - State:NC
Mailing Address - Zip Code:28138-7516
Mailing Address - Country:US
Mailing Address - Phone:704-279-5556
Mailing Address - Fax:704-255-1801
Practice Address - Street 1:417 N MAIN ST
Practice Address - Street 2:SUITE C CORPORATE SQUARE
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144-4376
Practice Address - Country:US
Practice Address - Phone:704-636-5522
Practice Address - Fax:702-636-5533
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2475101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)