Individual provider Active NPI

Ravine Renique Billy

  • Clinical Social Worker
  • Raleigh, NC
National Provider Identifier
1245963560
Registry record updated Jul 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P017881 Issued in NC
Practice address
5401 Six Forks Rd Ste 200
Raleigh, NC 27609-4462
Phone
(919) 886-4052
NPI assigned
Jul 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P017881 NC Primary

Addresses

Primary practice location

5401 Six Forks Rd Ste 200
Raleigh, NC 27609-4462

Mailing address

3950 Fairsted Dr Apt 456
Raleigh, NC 27612-4557
Phone (336) 870-9281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P017881NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Third Wave Psychotherapy, PLLC Clinical CurrentSince Jul 10, 2022 Accepting new patients
Anchor Perinatal Wellness, PLLC Clinical Past Accepting new patients
Allison Grubbs, LCSW, Lcas, PLLC Clinical Past Accepting new patients

Locations

5401 Six Forks Rd
Ste 200
Raleigh, NC 27609
Phone (919) 704-8449

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656979200000",
    "number": "1245963560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3950 FAIRSTED DR APT 456",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276124557",
            "telephone_number": "336-870-9281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 SIX FORKS RD STE 200",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276094462",
            "telephone_number": "919-886-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BILLY",
        "first_name": "RAVINE",
        "middle_name": "RENIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2022-07-05",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P017881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2022; 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.