Provider Demographics
NPI:1265296776
Name:RAINES, RUBY ANSLEY
Entity type:Individual
Prefix:
First Name:RUBY
Middle Name:ANSLEY
Last Name:RAINES
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 1:3850 TUNLAW RD NW APT 810
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20007-4861
Mailing Address - Country:US
Mailing Address - Phone:276-227-1616
Mailing Address - Fax:
Practice Address - Street 1:12007 SUNRISE VALLEY DR
Practice Address - Street 2:
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20191-3479
Practice Address - Country:US
Practice Address - Phone:703-522-2089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-06
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health