Healthcare Provider Details

I. General information

NPI: 1093609257
Provider Name (Legal Business Name): SUZANNE JARMAN RAINES LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SUZANNE JARMAN LCSW

II. Dates (important events)

Enumeration Date: 06/04/2025
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 N NC HWY 41
BEAULAVILLE NC
28518
US

IV. Provider business mailing address

191 N NC HWY 41
BEAULAVILLE NC
28518
US

V. Phone/Fax

Practice location:
  • Phone: 910-298-6293
  • Fax: 910-298-6293
Mailing address:
  • Phone: 910-298-6207
  • Fax: 910-298-6293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP022073
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: