Provider Demographics
NPI:1538990742
Name:STARKEY, RAVEN (CDCA, BSW)
Entity type:Individual
Prefix:
First Name:RAVEN
Middle Name:
Last Name:STARKEY
Suffix:
Gender:F
Credentials:CDCA, BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20220 CENTER RIDGE RD STE 110
Mailing Address - Street 2:
Mailing Address - City:ROCKY RIVER
Mailing Address - State:OH
Mailing Address - Zip Code:44116-3501
Mailing Address - Country:US
Mailing Address - Phone:440-356-7620
Mailing Address - Fax:440-356-7623
Practice Address - Street 1:20220 CENTER RIDGE RD STE 110
Practice Address - Street 2:
Practice Address - City:ROCKY RIVER
Practice Address - State:OH
Practice Address - Zip Code:44116-3501
Practice Address - Country:US
Practice Address - Phone:440-356-7620
Practice Address - Fax:440-356-7623
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCDCA.189374101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)