Healthcare Provider Details

I. General information

NPI: 1528191533
Provider Name (Legal Business Name): JAMMIE NOEL RAINEY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/13/2007
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 BRIAR CREEK RD STE BB400
CHARLOTTE NC
28205-6960
US

IV. Provider business mailing address

800 BRIAR CREEK RD STE BB400
CHARLOTTE NC
28205-6960
US

V. Phone/Fax

Practice location:
  • Phone: 704-408-3703
  • Fax: 980-299-8673
Mailing address:
  • Phone: 704-408-3703
  • Fax: 980-299-8673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2514
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: