Provider Demographics
NPI:1497088355
Name:RAINEY, KERRI LEANN (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:LEANN
Last Name:RAINEY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 N VAN BUREN ST
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-4453
Mailing Address - Country:US
Mailing Address - Phone:580-237-3432
Mailing Address - Fax:580-237-8433
Practice Address - Street 1:412 N VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-4453
Practice Address - Country:US
Practice Address - Phone:580-237-3432
Practice Address - Fax:580-237-8433
Is Sole Proprietor?:No
Enumeration Date:2009-09-10
Last Update Date:2009-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK28941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical