Healthcare Provider Details

I. General information

NPI: 1487756615
Provider Name (Legal Business Name): JOYCE H. RAINES M.ED, LPC, P.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 FRANKLIN SQUARE WAY SUITE B
EASLEY SC
29642
US

IV. Provider business mailing address

101 FRANKLIN SQUARE WAY SUITE B
EASLEY SC
29642
US

V. Phone/Fax

Practice location:
  • Phone: 864-859-0101
  • Fax:
Mailing address:
  • Phone: 864-859-0101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3520
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: