Provider Demographics
NPI:1255327243
Name:RAINWALKER, EMILIA (LICSW)
Entity Type:Individual
Prefix:MS
First Name:EMILIA
Middle Name:
Last Name:RAINWALKER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:187 MERRIAM HILL RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NH
Mailing Address - Zip Code:03048-3332
Mailing Address - Country:US
Mailing Address - Phone:603-878-3362
Mailing Address - Fax:603-878-3478
Practice Address - Street 1:33 MAIN ST
Practice Address - Street 2:
Practice Address - City:ASHBURNHAM
Practice Address - State:MA
Practice Address - Zip Code:01430-4200
Practice Address - Country:US
Practice Address - Phone:978-827-6055
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA110223101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP22310Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER