Provider Demographics
NPI:1043274285
Name:RAINEY, JOE SHARP (PHD)
Entity type:Individual
Prefix:DR
First Name:JOE
Middle Name:SHARP
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 1:8350 GREENSBORO DR
Mailing Address - Street 2:#805
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-3533
Mailing Address - Country:US
Mailing Address - Phone:703-734-1103
Mailing Address - Fax:703-506-4639
Practice Address - Street 1:8350 GREENSBORO DR
Practice Address - Street 2:#805
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-3533
Practice Address - Country:US
Practice Address - Phone:703-734-1103
Practice Address - Fax:703-506-4639
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001082103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0004588356OtherAETNA
VA7716095Medicaid
VAA147OtherCARE FIRST
VA031596OtherVALUE OPTIONS
VA163538OtherPHCS
VA217641OtherKAISER PERMANENTE
VA036902OtherANTHEM
VA199143OtherMHN
VA450912WCOtherNCPPO
VA036902OtherANTHEM