Provider Demographics
NPI:1548690126
Name:ADAMS, RAVEN (LPC, LSATP)
Entity type:Individual
Prefix:MS
First Name:RAVEN
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:LPC, LSATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201B ROSSER AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:VA
Mailing Address - Zip Code:22980-3540
Mailing Address - Country:US
Mailing Address - Phone:540-941-8933
Mailing Address - Fax:540-941-8935
Practice Address - Street 1:201B ROSSER AVE STE 2
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:VA
Practice Address - Zip Code:22980-3540
Practice Address - Country:US
Practice Address - Phone:540-941-8933
Practice Address - Fax:540-941-8935
Is Sole Proprietor?:No
Enumeration Date:2013-11-19
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0718000342101YA0400X
VA0701005622101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)