MEDICARE: RAINA SO COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1497613921
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAINA SO COUNSELING LLC

Provider Business Mailing Address
First Line	:	4539 N 22ND ST # 8199
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4639
Country	:	US
Telephone Number	:	626-214-8908
Fax Number	:

Provider Business Practice Location Address
First Line	:	4539 N 22ND ST # 8199
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-4639
Country	:	US
Telephone Number	:	626-214-8908
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	RAINA SO
Credential	:	LMFT
Telephone Number	:	480-589-5774

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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