Healthcare Provider Details

I. General information

NPI: 1770045429
Provider Name (Legal Business Name): JOAN TERESE RAYNER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2019
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2055 LIMESTONE RD STE 200A
WILMINGTON DE
19808-5536
US

IV. Provider business mailing address

2055 LIMESTONE RD STE 200A
WILMINGTON DE
19808-5536
US

V. Phone/Fax

Practice location:
  • Phone: 302-635-9111
  • Fax:
Mailing address:
  • Phone: 302-635-9111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0011832
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: