Provider Demographics
NPI:1598153017
Name:RAINES, STEPHANIE LEANN (NCC)
Entity Type:Individual
Prefix:MISS
First Name:STEPHANIE
Middle Name:LEANN
Last Name:RAINES
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1612 TAMPA DR
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-1146
Mailing Address - Country:US
Mailing Address - Phone:601-331-7833
Mailing Address - Fax:
Practice Address - Street 1:1612 TAMPA DR
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-1146
Practice Address - Country:US
Practice Address - Phone:601-331-7833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-06
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS340179OtherNATIONAL BOARD FOR CERTIFIED COUNSELORS NBCC