Provider Demographics
NPI:1316297120
Name:RAINWATER, SETH AVIE JAMES IV (PSYD, LCP)
Entity type:Individual
Prefix:DR
First Name:SETH
Middle Name:AVIE JAMES
Last Name:RAINWATER
Suffix:IV
Gender:M
Credentials:PSYD, LCP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:184 BUSINESS PARK DR
Mailing Address - Street 2:STE. 200
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-6533
Mailing Address - Country:US
Mailing Address - Phone:757-466-3336
Mailing Address - Fax:757-455-5750
Practice Address - Street 1:184 BUSINESS PARK DR
Practice Address - Street 2:STE. 200
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-6533
Practice Address - Country:US
Practice Address - Phone:757-466-3336
Practice Address - Fax:757-455-5750
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0810004629103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical