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General NPI Number Information
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NPI Number | 1831433697
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Entity Type | Organization
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Legal Business Name | D. M. RAINEY THERAPEUTIC SERVICES, LLC
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Dates
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Enumeration Date | 11/19/2012
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Last Update Date | 11/19/2012
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Provider Practice Location Address
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Address Line | 1613 E NORTH ST SUITE 105
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City | GREENVILLE
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State | SC
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Zip | 29607-1331
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Country | US
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Telephone | 864-245-7062
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Fax |
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Provider Business Mailing Address
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Address Line | 1613 E NORTH ST SUITE 105
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City | GREENVILLE
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State | SC
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Zip | 29607-1331
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Country | US
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Telephone | 864-245-7062
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DOROTHY RAINEY
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Credential | LPC
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Telephone | 864-245-7962
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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 | 5080
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License Number State | SC
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