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Individual

MRS. JODIE KAY GAINES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW, LCAC

Contact information

Practice address
1708 HIGH ST, SOUTH BEND, IN 46613-2633
(574) 406-6180
Mailing address
18352 LINDEN RD, ARGOS, IN 46501-9714
(219) 307-0668

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87001775A
IN
1041C0700X
Clinical Social Worker
Primary
34011629A
IN

Other

Enumeration date
08/24/2022
Last updated
02/16/2025
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