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General NPI Number Information
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NPI Number | 1356688097
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Entity Type | Individual
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Provider Name | ROBERT RAHAIM LPC-S
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Gender | Male
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Dates
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Enumeration Date | 01/15/2013
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Last Update Date | 03/11/2025
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Provider Practice Location Address
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Address Line | 6915 CRUMPLER BLVD STE A
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City | OLIVE BRANCH
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State | MS
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Zip | 38654-1907
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Country | US
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Telephone | 662-205-6818
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Fax |
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Provider Business Mailing Address
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Address Line | 8207 SHALLOW GLEN TRL
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City | CORDOVA
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State | TN
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Zip | 38016-1543
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Country | US
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Telephone | 662-205-6861
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0413
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License Number State | MS
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