Provider Demographics
NPI:1821873324
Name:RAINEY, REBECCA (LCSW - BACS)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:RAINEY
Suffix:
Gender:F
Credentials:LCSW - BACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1205 SAINT CHARLES AVE APT 703
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-4355
Mailing Address - Country:US
Mailing Address - Phone:504-228-3076
Mailing Address - Fax:
Practice Address - Street 1:1205 SAINT CHARLES AVE APT 703
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-4355
Practice Address - Country:US
Practice Address - Phone:504-228-3076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13055101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health