Provider Demographics
NPI:1003556010
Name:RAINES, ELIZABETH M (PHD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:RAINES
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 SAGE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-6995
Mailing Address - Country:US
Mailing Address - Phone:919-942-4166
Mailing Address - Fax:919-942-8693
Practice Address - Street 1:205 SAGE RD STE 201
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-6995
Practice Address - Country:US
Practice Address - Phone:919-942-4166
Practice Address - Fax:919-942-8693
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-29
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
NC6651103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty