Ariel Lawrence Ravid, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY60595515 Issued in WA

Practice address

2225 E Murray Holladay Rd
Suite 116
Holladay, UT 84117

Phone

(877) 919-4521

Fax

(385) 276-1377

NPI assigned

Nov 5, 2015

Last updated

Nov 14, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jan 1, 2016 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Ebtsl Psychiatry, PLLC

  • Child & Adolescent Psychiatry Physician
  • Holladay, UT
  • NPI 1275369563
  NPD
• Evidence Based Treatment Centers of Salt Lake City, PLLC

  • Clinical Psychologist
  • Holladay, UT
  • NPI 1326783689
  NPD

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668384000000",
    "number": "1518330083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 E MURRAY HOLLADAY RD",
            "address_2": "SUITE 116",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "84117",
            "telephone_number": "877-919-4521",
            "fax_number": "385-276-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 E MURRAY HOLLADAY RD",
            "address_2": "SUITE 116",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "84117",
            "telephone_number": "877-919-4521",
            "fax_number": "385-276-1377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVID",
        "first_name": "ARIEL",
        "middle_name": "LAWRENCE",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-05",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60595515",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY60595515",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "UT",
            "license": "12441967-2501",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Purple Coffee Therapy
• Q Porschatis LCSW, LLC
• R Brady Perdue DDS, PLLC
• Roxanne Settareh Rahimi, LCSW
• Sara Rae Rands, ACMHC
• Carolynn Redd-Recksiek, MFT
• Raelene Reeve, COTA/L
• Kyle M Reid Jr., AMFT
• Renewrx
• Nicole Pehrson Reynard, ACMHC

• Clinical Psychologist in Holladay, UT
• Providers in Holladay, UT by specialty
• Clinical Psychologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.