Provider Demographics
NPI:1427074301
Name:RAINS, DEWEY (LCSW)
Entity type:Individual
Prefix:
First Name:DEWEY
Middle Name:
Last Name:RAINS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1080
Mailing Address - Street 2:
Mailing Address - City:BURKESVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42717-1080
Mailing Address - Country:US
Mailing Address - Phone:606-676-0638
Mailing Address - Fax:606-676-0789
Practice Address - Street 1:404 STEVE DR STE 102
Practice Address - Street 2:
Practice Address - City:RUSSELL SPRINGS
Practice Address - State:KY
Practice Address - Zip Code:42642-4622
Practice Address - Country:US
Practice Address - Phone:606-866-3161
Practice Address - Fax:606-866-3163
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY11931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY0500305Medicare PIN
KY0500751Medicare PIN
KY0501106Medicare PIN
KY0500407Medicare PIN