Provider Demographics
NPI:1497031900
Name:RAINEY, TIMOTHY FELIPE (LPCA)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:FELIPE
Last Name:RAINEY
Suffix:
Gender:M
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 BALFOUR DOWNS CIR
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-7763
Mailing Address - Country:US
Mailing Address - Phone:919-457-7796
Mailing Address - Fax:919-457-7796
Practice Address - Street 1:1320 BALFOUR DOWNS CIR
Practice Address - Street 2:
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-7763
Practice Address - Country:US
Practice Address - Phone:919-457-7796
Practice Address - Fax:919-497-5407
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-27
Last Update Date:2011-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA9069101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional