Individual provider Active NPI

Shannon Michelle Rainey, LPC

  • Counselor
  • Hattiesburg, MS
National Provider Identifier
1508151135
Registry record updated Jun 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
1017 Issued in MS
Practice address
607 Corinne St # a-2
Hattiesburg, MS 39401-3831
Phone
(601) 268-8796
Fax
(601) 336-7563
NPI assigned
Jun 11, 2011
Last updated
Jun 11, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 1017 MS Primary
Professional Counselor 101YP2500X 1017 MS

Addresses

Primary practice location

607 Corinne St # a-2
Hattiesburg, MS 39401-3831

Mailing address

607 Corinne St # a-2
Hattiesburg, MS 39401-3831
Phone (601) 268-8796

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1017MSMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
March HCT Counselor Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1307750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307750400000",
    "number": "1508151135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 CORINNE ST # A-2",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394013831",
            "telephone_number": "601-268-8796",
            "fax_number": "601-336-7563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 CORINNE ST # A-2",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394013831",
            "telephone_number": "601-268-8796",
            "fax_number": "601-336-7563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINEY",
        "first_name": "SHANNON",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-11",
        "last_updated": "2011-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MS",
            "license": "1017",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MS",
            "license": "1017",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.