Provider Demographics
NPI:1831433697
Name:D. M. RAINEY THERAPEUTIC SERVICES, LLC
Entity type:Organization
Organization Name:D. M. RAINEY THERAPEUTIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAINEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:864-245-7962
Mailing Address - Street 1:1613 E NORTH ST
Mailing Address - Street 2:SUITE 105
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-1331
Mailing Address - Country:US
Mailing Address - Phone:864-245-7062
Mailing Address - Fax:
Practice Address - Street 1:1613 E NORTH ST
Practice Address - Street 2:SUITE 105
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-1331
Practice Address - Country:US
Practice Address - Phone:864-245-7062
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-19
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5080251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health