MEDICARE: REBECCA RAINEY LCSW - BACS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	13055	LA

General Provider Information

NPI Number	:	1821873324
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA RAINEY LCSW - BACS

Provider Business Mailing Address
First Line	:	1205 SAINT CHARLES AVE APT 703
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70130-4355
Country	:	US
Telephone Number	:	504-228-3076
Fax Number	:

Provider Business Practice Location Address
First Line	:	1205 SAINT CHARLES AVE APT 703
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70130-4355
Country	:	US
Telephone Number	:	504-228-3076
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2023
Last Update Date	:	08/31/2023

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