| Doctor Name: | LAURA A GAINES |
| NPI Number: | 1306987847 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | |
| Business Practice Address: | 118 West Union St Munfordville, KY - 42765 |
| Business Phone Number: | 2705249883 |
| Business Fax Number: | 2705240437 |
| Mailing Address: | 24004 Louisville Rd, PARK CITY |
| State: | KY |
| Postal Code: | 421609503 |
| Phone Number: | 2709015000 |
| Fax Number: | 2708425268 |
| NPI Enumeration Date: | 02/09/2007 |
| NPI Last Update Date: | 06/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |