Provider Demographics
NPI:1043967292
Name:GAGNE, ARIEL (LISW-CP)
Entity type:Individual
Prefix:MS
First Name:ARIEL
Middle Name:
Last Name:GAGNE
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:ARIEL
Other - Middle Name:C
Other - Last Name:GAGNE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW-CP
Mailing Address - Street 1:289 GREENTREE ST
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-5591
Mailing Address - Country:US
Mailing Address - Phone:864-542-6185
Mailing Address - Fax:
Practice Address - Street 1:289 GREENTREE ST
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-5591
Practice Address - Country:US
Practice Address - Phone:864-542-6185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-08
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC149771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical