Provider Demographics
NPI:1225742968
Name:GRAVIE, RAYMOND SCOTT (LCSW)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:SCOTT
Last Name:GRAVIE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 N 31ST RD
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-5008
Mailing Address - Country:US
Mailing Address - Phone:305-244-8485
Mailing Address - Fax:
Practice Address - Street 1:1307 N 31ST RD
Practice Address - Street 2:
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-5008
Practice Address - Country:US
Practice Address - Phone:305-244-8485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW135601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical