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General NPI Number Information
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NPI Number | 1447896881
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Entity Type | Individual
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Provider Name | DANIELLE SUE RAVELING LCSW-PIP
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Gender | Female
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Dates
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Enumeration Date | 11/20/2019
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Last Update Date | 08/16/2024
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Provider Practice Location Address
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Address Line | 301 1ST AVE STE 200
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City | ROCK RAPIDS
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State | IA
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Zip | 51246-1550
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Country | US
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Telephone | 605-494-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 420 S HENRY ST
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City | PIERRE
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State | SD
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Zip | 57501-4515
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Country | US
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Telephone | 605-494-1500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 22041902
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 6153
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License Number State | SD
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