Healthcare Provider Details

I. General information

NPI: 1295829026
Provider Name (Legal Business Name): LIFECARE PSYCHOLOGY GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 04/27/2024
Certification Date: 04/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

549 W EVANS ST
FLORENCE SC
29501-3407
US

IV. Provider business mailing address

549 W EVANS ST
FLORENCE SC
29501-3407
US

V. Phone/Fax

Practice location:
  • Phone: 843-667-4949
  • Fax: 843-667-3349
Mailing address:
  • Phone: 843-667-4949
  • Fax: 843-667-3349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number StateSC

VIII. Authorized Official

Name: DR. SETH RAINWATER IV
Title or Position: MANAGING PARTNER
Credential: PSYD
Phone: 843-667-4949