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General NPI Number Information
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NPI Number | 1346965316
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Entity Type | Organization
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Legal Business Name | DR. RAINNEY & ASSOC. BHS, PLLC
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Dates
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Enumeration Date | 10/11/2022
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 6013 MANOR HOUSE TRL
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City | MOSELEY
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State | VA
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Zip | 23120-2248
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Country | US
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Telephone | 804-248-6964
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Fax | 877-336-5519
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Provider Business Mailing Address
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Address Line | 6013 MANOR HOUSE TRL
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City | MOSELEY
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State | VA
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Zip | 23120-2248
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Country | US
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Telephone | 804-248-6964
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Fax | 877-336-5519
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Authorized Official
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Title or Position | CEO/CLINICAL DIRECTOR/OWNER
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Name | DR. KEMBERLY LILES RAINNEY
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Credential | LPC, LSATP
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Telephone | 804-248-6964
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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