Provider Demographics
NPI:1922895382
Name:RAIT, ROBERT ALEXANDER
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:ALEXANDER
Last Name:RAIT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:653 GRAND PARKE DR
Mailing Address - Street 2:
Mailing Address - City:ST JOHNS
Mailing Address - State:FL
Mailing Address - Zip Code:32259-4281
Mailing Address - Country:US
Mailing Address - Phone:904-460-3492
Mailing Address - Fax:
Practice Address - Street 1:35 S PEACHTREE ST
Practice Address - Street 2:
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30071-2503
Practice Address - Country:US
Practice Address - Phone:904-460-3492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker