Provider Demographics
NPI:1942494711
Name:RINEY, CHARLES TIMOTHY (PSYD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:TIMOTHY
Last Name:RINEY
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:C.
Other - Middle Name:TIMOTHY
Other - Last Name:RINEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:630 HILLCREST RD NW STE 400
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-6893
Mailing Address - Country:US
Mailing Address - Phone:678-769-4088
Mailing Address - Fax:
Practice Address - Street 1:630 HILLCREST RD NW STE 400
Practice Address - Street 2:
Practice Address - City:LILBURN
Practice Address - State:GA
Practice Address - Zip Code:30047-6893
Practice Address - Country:US
Practice Address - Phone:678-769-4088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-04
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY003119103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical