Raven Rock Wellness Center LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

RAVEN ROCK WELLNESS CENTER LLC

Practice address

221 Halls Rd
Stanton, KY 40380-2027

Phone

(606) 775-0515

Fax

(606) 552-0964

NPI assigned

Jan 20, 2023

Organization subpart

No

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

Authorized official

Name

Dana Conn, LCSW

Title

Member

Phone

(606) 775-0515

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1674172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674172800000",
    "number": "1114632577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 HALLS RD",
            "city": "STANTON",
            "state": "KY",
            "postal_code": "403802027",
            "telephone_number": "606-775-0515",
            "fax_number": "606-552-0964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 HALLS RD",
            "city": "STANTON",
            "state": "KY",
            "postal_code": "403802027",
            "telephone_number": "606-775-0515",
            "fax_number": "606-552-0964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVEN ROCK WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-20",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A",
        "authorized_official_last_name": "CONN",
        "authorized_official_first_name": "DANA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "606-775-0515",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Powell County Health Department
• Powell County Schools
• Prostep Rehabilitation
• Glenn Riego Puertollano, MD
• Raven Rock Health &Wellness
• Regional Physicians Corporation II
• Jennifer Marie Reynolds, OT
• Shellie Roberts, CSW
• Donald W Rogers, MA
• Alexis Desiree Sigourney

• Adult Mental Health Clinic/Center in Stanton, KY
• Providers in Stanton, KY by specialty
• Adult Mental Health Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2023; 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.