Provider Demographics
NPI:1891944799
Name:RAINEY, GARY M (LICSW)
Entity Type:Individual
Prefix:MR
First Name:GARY
Middle Name:M
Last Name:RAINEY
Suffix:
Gender:M
Credentials:LICSW
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Mailing Address - Street 1:88 MCGREGGOR ST SUITE 105
Mailing Address - Street 2:CMC OUTPATIENT MEDICATION AND COUNSELING PROGRAM
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03102-3730
Mailing Address - Country:US
Mailing Address - Phone:603-663-6200
Mailing Address - Fax:603-663-6257
Practice Address - Street 1:88 MCGREGGOR ST SUITE 105
Practice Address - Street 2:CMC OUTPATIENT MEDICATION AND COUNSELING PROGRAM
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03102-3730
Practice Address - Country:US
Practice Address - Phone:603-663-6200
Practice Address - Fax:603-663-6257
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH2291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical