Provider Demographics
NPI:1528860731
Name:RAVE THERAPY PLLC
Entity type:Organization
Organization Name:RAVE THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:SHAY
Authorized Official - Last Name:BARRY
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:206-643-2572
Mailing Address - Street 1:314 WILLIAMS AVE S UNIT 145
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-9713
Mailing Address - Country:US
Mailing Address - Phone:206-643-2572
Mailing Address - Fax:
Practice Address - Street 1:314 WILLIAMS AVE S UNIT 145
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-9713
Practice Address - Country:US
Practice Address - Phone:206-643-2572
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-26
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty