Raven Shonice Traylor, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW009366 Issued in GA

Practice address

1016 Mandalay CT SW
Lilburn, GA 30047-4225

Phone

(318) 267-9945

NPI assigned

Mar 1, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Bluegold Health LLC

  • Mental Health Counselor
  • Cumming, GA
  • NPI 1285483891
  Medicare reassignment NPD

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

{
    "created_epoch": "1551398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750204800000",
    "number": "1467919068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 MANDALAY CT SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300474225",
            "telephone_number": "318-267-9945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 MANDALAY CT SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300474225",
            "telephone_number": "318-267-9945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "806 N 31st St Ste D",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "LA",
            "postal_code": "712013900",
            "country_code": "US",
            "telephone_number": "318-855-3868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRAYLOR",
        "first_name": "RAVEN",
        "middle_name": "SHONICE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-01",
        "last_updated": "2025-06-18",
        "certification_date": "2025-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW009366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• My Loan Thi Tran, DMD
• Quang Huy Vu Tran
• Trinh Tu Tran
• Transformations Therapy of Atlanta, LLC
• Transformations Therapy of Atlanta, LLC
• Huy Trinh
• Toan Trinh, RPH
• Trivium South Healthcare, LLC
• TRJ Enterprise and Company LLC
• Truecare Medical LLC

• Clinical Social Worker in Lilburn, GA
• Providers in Lilburn, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.