Provider Demographics
NPI:1174377899
Name:ALLEN-MCGEE, RAVEN S (LMFT)
Entity type:Individual
Prefix:
First Name:RAVEN
Middle Name:S
Last Name:ALLEN-MCGEE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1491 NW 33RD WAY
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33311-4930
Mailing Address - Country:US
Mailing Address - Phone:954-993-3930
Mailing Address - Fax:
Practice Address - Street 1:8108 NW 78TH ST
Practice Address - Street 2:
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2071
Practice Address - Country:US
Practice Address - Phone:954-804-5659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT4876106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist