Individual provider Active NPI

Tito Ravine, CASE MANAGER

  • Behavior Technician
  • Conway, AR
National Provider Identifier
1346729605
Registry record updated Apr 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
License
RBT-23-293969 Issued in AR
Practice address
1301 Museum Rd
Conway, AR 72032-4739
Phone
(501) 358-6535
Fax
(501) 358-6536
NPI assigned
Aug 8, 2018
Last updated
Apr 10, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X NU
Behavior Technician 106S00000X RBT-23-293969 AR Primary

Addresses

Primary practice location

1301 Museum Rd
Conway, AR 72032-4739

Mailing address

1301 Museum Rd
Conway, AR 72032-4739
Phone (501) 358-6535

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
RBT-23-293969ARMDBehavior Technician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Medical Group CurrentSince Sep 17, 2023 Accepting new patients
Reach Therapy Services LLC CurrentSince Sep 17, 2023 Accepting new patients

Locations

1301 Museum Rd
Conway, AR 72032
Phone (501) 358-6535

Organizations & group practices 2

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": "1533686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1346729605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 MUSEUM RD",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720324739",
            "telephone_number": "501-358-6535",
            "fax_number": "501-358-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 MUSEUM RD",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720324739",
            "telephone_number": "501-358-6535",
            "fax_number": "501-358-6536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVINE",
        "first_name": "TITO",
        "credential": "CASE MANAGER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-08",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "AR",
            "license": "RBT-23-293969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2026; 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.