Provider Demographics
NPI:1114271350
Name:RAVEIA, MARY CLAIRE (LCPC)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:CLAIRE
Last Name:RAVEIA
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 BRIERGREEN CT
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-8435
Mailing Address - Country:US
Mailing Address - Phone:909-225-0340
Mailing Address - Fax:240-964-8586
Practice Address - Street 1:806 BRIERGREEN CT
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-8435
Practice Address - Country:US
Practice Address - Phone:909-225-0340
Practice Address - Fax:240-964-8586
Is Sole Proprietor?:No
Enumeration Date:2012-11-08
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC4532101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional