Provider Demographics
NPI:1134007347
Name:NEELY, RAGEN (SWT)
Entity type:Individual
Prefix:
First Name:RAGEN
Middle Name:
Last Name:NEELY
Suffix:
Gender:X
Credentials:SWT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12741 RAVENWOOD DR
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-8882
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:440-285-8321
Practice Address - Street 1:12741 RAVENWOOD DR
Practice Address - Street 2:
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-8882
Practice Address - Country:US
Practice Address - Phone:440-285-8169
Practice Address - Fax:440-285-8321
Is Sole Proprietor?:No
Enumeration Date:2025-08-25
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2504335-TRNE1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical