Provider Demographics
NPI:1639471469
Name:RAINEY PSYCHOLOGICAL SERVICES, P.C.
Entity Type:Organization
Organization Name:RAINEY PSYCHOLOGICAL SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMMIE
Authorized Official - Middle Name:NOEL
Authorized Official - Last Name:RAINEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:704-408-3703
Mailing Address - Street 1:800 BRIAR CREEK RD STE FF301
Mailing Address - Street 2:7310 MIDDLEBURY PLACE CHARLOTTE NC 28212
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28205-6971
Mailing Address - Country:US
Mailing Address - Phone:704-408-3703
Mailing Address - Fax:704-537-9356
Practice Address - Street 1:800 BRIAR CREEK RD STE FF301
Practice Address - Street 2:7310 MIDDLEBURY PLACE CHARLOTTE NC 28212
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28205-6971
Practice Address - Country:US
Practice Address - Phone:704-408-3703
Practice Address - Fax:704-537-9356
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-30
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health