MEDICARE: MR. KAMERON RAINEY MS, LBA

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	103K00000X	Behavior Analyst	2273	CT
2	106S00000X	Behavior Technician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720689227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KAMERON RAINEY MS, LBA

Provider Business Mailing Address
First Line	:	85 MCDERMOTT CIR
Second Line	:
City	:	HAMDEN
State	:	CT
Zip	:	06518-1719
Country	:	US
Telephone Number	:	813-928-6731
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 MERRITT BLVD STE 25
Second Line	:
City	:	TRUMBULL
State	:	CT
Zip	:	06611-5450
Country	:	US
Telephone Number	:	888-754-0398
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2020
Last Update Date	:	01/15/2026

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