Provider Demographics
NPI:1790157956
Name:RAINEY, NICOLE (LMHC, ATR)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:RAINEY
Suffix:
Gender:F
Credentials:LMHC, ATR
Other - Prefix:MRS
Other - First Name:NICOLE
Other - Middle Name:
Other - Last Name:RAINEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2509 BARRINGTON CIR STE 112
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-6801
Mailing Address - Country:US
Mailing Address - Phone:850-462-2599
Mailing Address - Fax:
Practice Address - Street 1:2509 BARRINGTON CIR STE 112
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-6801
Practice Address - Country:US
Practice Address - Phone:850-462-2599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2020-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health