Individual
RANDY RAINWATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
2002 S FILLMORE ST, LITTLE ROCK, AR 72204-4909
(501) 661-0720
(501) 687-0839
Mailing address
58 BRIARWOOD CIR, CONWAY, AR 72034-2921
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
P9002006
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCBS
5W477
AR
Enumeration date
04/19/2007
Last updated
07/08/2007
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