Provider Demographics
NPI:1093689796
Name:RAINES, SHEBRAIL LATREECE (CPSS)
Entity type:Individual
Prefix:
First Name:SHEBRAIL
Middle Name:LATREECE
Last Name:RAINES
Suffix:
Gender:F
Credentials:CPSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 S MASSEY ST
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:NC
Mailing Address - Zip Code:27576-3008
Mailing Address - Country:US
Mailing Address - Phone:919-750-1016
Mailing Address - Fax:
Practice Address - Street 1:206 S MASSEY ST
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:NC
Practice Address - Zip Code:27576-3008
Practice Address - Country:US
Practice Address - Phone:919-750-1016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-03
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2025-14369-01175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist