Provider Demographics
NPI:1518754266
Name:GAINOR, KACY (CRC)
Entity type:Individual
Prefix:MRS
First Name:KACY
Middle Name:
Last Name:GAINOR
Suffix:
Gender:F
Credentials:CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 GLENDON CT
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-3246
Mailing Address - Country:US
Mailing Address - Phone:501-426-3086
Mailing Address - Fax:614-468-2820
Practice Address - Street 1:5500 GLENDON CT
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-3246
Practice Address - Country:US
Practice Address - Phone:501-426-3086
Practice Address - Fax:614-468-2820
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-24
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1175614225C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor