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General NPI Number Information
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NPI Number | 1245744796
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Entity Type | Organization
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Legal Business Name | RAVEN INSTITUTE, INC.
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Dates
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Enumeration Date | 11/20/2017
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Last Update Date | 07/20/2023
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Provider Practice Location Address
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Address Line | 2879 15TH ST
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City | HINESVILLE
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State | GA
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Zip | 31313-8109
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Country | US
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Telephone | 912-599-4740
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Fax | 912-599-4740
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Provider Business Mailing Address
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Address Line | 2879 15TH ST
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City | HINESVILLE
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State | GA
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Zip | 31313-8109
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Country | US
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Telephone | 912-599-4740
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Fax | 912-599-4740
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. TROY FOSKEY JR.
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Credential | PHD, ND, FMD
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Telephone | 912-599-4740
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number |
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License Number State |
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