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General NPI Number Information
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NPI Number | 1457756900
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Entity Type | Individual
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Provider Name | ALICIA GRACE RAINWATER LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/27/2014
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 139 SYCAMORE RD
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City | HAVERTOWN
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State | PA
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Zip | 19083-3507
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Country | US
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Telephone | 512-653-8233
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Fax |
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Provider Business Mailing Address
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Address Line | 139 SYCAMORE RD
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City | HAVERTOWN
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State | PA
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Zip | 19083-3507
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Country | US
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Telephone | 512-653-8233
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 218801
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 57832
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW022908
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License Number State | PA
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