NPIMap

Individual provider Active NPI

Kemberly Liles Rainney, L.P.C., L.S.A.T.P.

  • Professional Counselor
  • Moseley, VA
National Provider Identifier
1821204959
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701002907 Issued in VA
Practice address
6013 Manor House TRL
Moseley, VA 23120-2248
Phone
(804) 248-6964
Fax
(866) 210-2370
NPI assigned
May 15, 2007
Last updated
Sep 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 0718000086 VA
Professional Counselor 101YP2500X 0701002907 VA Primary

Addresses

Primary practice location

6013 Manor House TRL
Moseley, VA 23120-2248

Mailing address

6013 Manor House TRL
Moseley, VA 23120-2248
Phone (804) 248-6964

Other identifiers 1

IdentifierTypeStateIssuer
010023271MedicaidVA

Other names 1

  • Kemberly Antoinette Liles Former name

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
0718000086VAMDAddiction (Substance Use Disorder) Counselor
0701002907VAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Rainney & Assoc. BHS, PLLC Current Accepting new patients
Life Young Adult Services, LLC Current Accepting new patients

Organizations & group practices 3

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": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1821204959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6013 MANOR HOUSE TRL",
            "city": "MOSELEY",
            "state": "VA",
            "postal_code": "231202248",
            "telephone_number": "804-248-6964",
            "fax_number": "866-210-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6013 MANOR HOUSE TRL",
            "city": "MOSELEY",
            "state": "VA",
            "postal_code": "231202248",
            "telephone_number": "804-248-6964",
            "fax_number": "866-210-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAINNEY",
        "first_name": "KEMBERLY",
        "middle_name": "LILES",
        "name_prefix": "Dr.",
        "credential": "L.P.C., L.S.A.T.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2022-09-02",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0718000086",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701002907",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010023271",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KEMBERLY",
            "last_name": "LILES",
            "middle_name": "ANTOINETTE",
            "credential": "L.P.C., L.S.A.T.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Moseley, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; 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.