Raven Counseling Services, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

LPC004669 Issued in GA

Legal business name

RAVEN COUNSELING SERVICES, INC.

Practice address

867 Commerce Dr SW
Suite 200-400
Conyers, GA 30094-6604

Phone

(770) 679-4043

Fax

(770) 679-4915

NPI assigned

Sep 20, 2011

Organization subpart

No

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

Authorized official

Name

Cassandra E Conton, PH.D, LPC

Title

Ceo

Phone

(770) 679-4043

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1425513600000",
    "number": "1043593791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "867 COMMERCE DR SW",
            "address_2": "SUITE 200-400",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946604",
            "telephone_number": "770-679-4043",
            "fax_number": "770-679-4915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "867 COMMERCE DR SW",
            "address_2": "SUITE 200-400",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946604",
            "telephone_number": "770-679-4043",
            "fax_number": "770-679-4915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVEN COUNSELING SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-20",
        "last_updated": "2015-03-05",
        "status": "A",
        "authorized_official_last_name": "CONTON",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "770-679-4043",
        "authorized_official_credential": "PH.D, LPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "GA",
            "license": "LPC004669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2015; 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.