Provider Demographics
NPI:1962058453
Name:RAINEY, ABBY (LMSW-C, RPT)
Entity type:Individual
Prefix:
First Name:ABBY
Middle Name:
Last Name:RAINEY
Suffix:
Gender:F
Credentials:LMSW-C, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 W MAIN ST STE 2600
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-5191
Mailing Address - Country:US
Mailing Address - Phone:989-402-3340
Mailing Address - Fax:
Practice Address - Street 1:240 W MAIN ST STE 2600
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-5191
Practice Address - Country:US
Practice Address - Phone:989-402-3340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801111271104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker