Healthcare Provider Details

I. General information

NPI: 1932030673
Provider Name (Legal Business Name): ADAM RAINEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

775 W DRAHNER RD
OXFORD MI
48371-4866
US

IV. Provider business mailing address

775 W DRAHNER RD
OXFORD MI
48371-4866
US

V. Phone/Fax

Practice location:
  • Phone: 248-969-5000
  • Fax:
Mailing address:
  • Phone: 248-969-5000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberSP0000001017964
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: