Provider Demographics
NPI:1336791987
Name:RAINFALL THERAPY AND CONSULTING, PLLC
Entity type:Organization
Organization Name:RAINFALL THERAPY AND CONSULTING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CIMENA
Authorized Official - Middle Name:J
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:651-260-9262
Mailing Address - Street 1:7595 CURRELL BLVD UNIT 251523
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-2612
Mailing Address - Country:US
Mailing Address - Phone:651-260-9262
Mailing Address - Fax:
Practice Address - Street 1:2322 MAMIE AVE E
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55119-5958
Practice Address - Country:US
Practice Address - Phone:651-260-9262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-14
Last Update Date:2019-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)