Provider Demographics
NPI:1174861785
Name:RAINEY, MAURICE JAMES
Entity Type:Individual
Prefix:
First Name:MAURICE
Middle Name:JAMES
Last Name:RAINEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2618 AUBRY ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-2208
Mailing Address - Country:US
Mailing Address - Phone:504-943-1625
Mailing Address - Fax:
Practice Address - Street 1:2626 CHARLES DR
Practice Address - Street 2:
Practice Address - City:CHALMETTE
Practice Address - State:LA
Practice Address - Zip Code:70043-3779
Practice Address - Country:US
Practice Address - Phone:504-278-4006
Practice Address - Fax:504-278-4007
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-17
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker