Provider Demographics
NPI:1487258463
Name:RAVAN, AHNA DENETE (LPC)
Entity type:Individual
Prefix:
First Name:AHNA
Middle Name:DENETE
Last Name:RAVAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 ROCK MANOR CT
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35756-5809
Mailing Address - Country:US
Mailing Address - Phone:256-374-9310
Mailing Address - Fax:
Practice Address - Street 1:190 LIME QUARRY RD STE 111
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-8975
Practice Address - Country:US
Practice Address - Phone:256-278-2802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-30
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional