Raveon1947

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

RAVEON1947

Practice address

9040 Town Center Parkway
Bradenton, FL 34202-3420

Phone

(941) 685-0265

Fax

(941) 552-5650

NPI assigned

Aug 21, 2018

Last updated

Aug 21, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. David L Kaus, MA, LMHC

Title

Owner

Phone

(941) 685-0265

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1534809600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534809600000",
    "number": "1205317930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 TOWN CENTER PKWY",
            "city": "LAKEWOOD RANCH",
            "state": "FL",
            "postal_code": "342024101",
            "telephone_number": "941-685-0265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 TOWN CENTER PARKWAY",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342023420",
            "telephone_number": "941-685-0265",
            "fax_number": "941-552-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVEON1947",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-21",
        "last_updated": "2018-08-21",
        "status": "A",
        "authorized_official_last_name": "KAUS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "941-685-0265",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MA, LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Clinic/Center (Including Community Mental Health Center) in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; 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.