Individual
MR. MICHAEL DAN GAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW, BCD
Contact information
Practice address
2944 RAY WEILAND DR, BAKER, LA 70714-3250
(225) 636-2638
(225) 778-5068
Mailing address
PO BOX 157, BAKER, LA 70704-0157
(225) 636-2638
(225) 778-5068
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1656
LA
251S00000X
Community/Behavioral Health Agency
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1438341
—
LA
Enumeration date
08/05/2006
Last updated
08/28/2017
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