Provider Demographics
NPI:1225218753
Name:KAINAYA, RITA TERESA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:RITA
Middle Name:TERESA
Last Name:KAINAYA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10136 PURITAN ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48238-1058
Mailing Address - Country:US
Mailing Address - Phone:313-961-4582
Mailing Address - Fax:313-345-0327
Practice Address - Street 1:10136 PURITAN ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48238-1058
Practice Address - Country:US
Practice Address - Phone:313-961-4582
Practice Address - Fax:313-345-0327
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801084525104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801084525OtherLMSW