Provider Demographics
NPI:1588858310
Name:RINEHART, LARRY WAYNE (LMSW)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:WAYNE
Last Name:RINEHART
Suffix:
Gender:M
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:PO BOX 281
Mailing Address - Street 2:17326 SECOND ST.
Mailing Address - City:ARCADIA
Mailing Address - State:MI
Mailing Address - Zip Code:49613-0281
Mailing Address - Country:US
Mailing Address - Phone:231-889-3773
Mailing Address - Fax:
Practice Address - Street 1:17326 SECOND ST.
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:MI
Practice Address - Zip Code:49613-0281
Practice Address - Country:US
Practice Address - Phone:231-889-3773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010637471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical