=====================================================
General NPI Number Information
=====================================================
NPI Number | 1609766955
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RAINWATER COUNSELING, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/08/2025
-----------------------------------------------------
Last Update Date | 07/08/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 83 ORCHARD ST
-----------------------------------------------------
City | LONE GROVE
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73443-6443
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 580-630-4229
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 1732
-----------------------------------------------------
City | LONE GROVE
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73443-1732
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 580-630-4229
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LPC AND OWNER
-----------------------------------------------------
Name | CAROLYN J RAINWATER
-----------------------------------------------------
Credential | LPC
-----------------------------------------------------
Telephone | 580-630-4229
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------