Provider Demographics
NPI:1043274285
Name:RAINEY, JOE S (PHD)
Entity type:Individual
Prefix:DR
First Name:JOE
Middle Name:S
Last Name:RAINEY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17201 QUAKER LANE
Mailing Address - Street 2:#QL-101
Mailing Address - City:SANDY SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20860-1224
Mailing Address - Country:US
Mailing Address - Phone:703-343-0368
Mailing Address - Fax:703-506-4639
Practice Address - Street 1:17201 QUAKER LANE
Practice Address - Street 2:#QL-101
Practice Address - City:SANDY SPRING
Practice Address - State:MD
Practice Address - Zip Code:20860-1224
Practice Address - Country:US
Practice Address - Phone:703-343-0368
Practice Address - Fax:703-506-4639
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01647103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA036902OtherANTHEM
VA163538OtherPHCS
VA217641OtherKAISER PERMANENTE
VAA147OtherCARE FIRST
VA031596OtherVALUE OPTIONS
VA450912WCOtherNCPPO
VA7716095Medicaid
VA0004588356OtherAETNA
VA199143OtherMHN
VA036902OtherANTHEM