Provider Demographics
NPI:1871181669
Name:RAINEY, SISILY (LPC)
Entity Type:Individual
Prefix:
First Name:SISILY
Middle Name:
Last Name:RAINEY
Suffix:
Gender:F
Credentials:LPC
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 1966
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77383-1966
Mailing Address - Country:US
Mailing Address - Phone:832-527-6977
Mailing Address - Fax:
Practice Address - Street 1:555 SPRING PARK CENTER BLVD APT 9308
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77373-8253
Practice Address - Country:US
Practice Address - Phone:183-252-7697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79713101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health