Provider Demographics
NPI:1700523024
Name:WHITE, RAINA
Entity type:Individual
Prefix:
First Name:RAINA
Middle Name:
Last Name:WHITE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 BUCK RD
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:VA
Mailing Address - Zip Code:22642-5212
Mailing Address - Country:US
Mailing Address - Phone:170-385-9015
Mailing Address - Fax:
Practice Address - Street 1:109 E 6TH ST
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-3407
Practice Address - Country:US
Practice Address - Phone:540-635-3518
Practice Address - Fax:413-702-9031
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor