Provider Demographics
NPI:1033739446
Name:RAVA, EMMA SIMONE (MSW)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:SIMONE
Last Name:RAVA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 HICKORY HILL RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-9344
Mailing Address - Country:US
Mailing Address - Phone:703-999-2500
Mailing Address - Fax:
Practice Address - Street 1:205 HICKORY HILL RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-9344
Practice Address - Country:US
Practice Address - Phone:703-999-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-26
Last Update Date:2020-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC114451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical