Provider Demographics
NPI:1558801274
Name:CURLING, RAVEN GEORGETTE (MA, LPC)
Entity Type:Individual
Prefix:MISS
First Name:RAVEN
Middle Name:GEORGETTE
Last Name:CURLING
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10330 S GREEN ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-3012
Mailing Address - Country:US
Mailing Address - Phone:312-714-5279
Mailing Address - Fax:
Practice Address - Street 1:1032 W SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-1537
Practice Address - Country:US
Practice Address - Phone:312-915-8844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178011943101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional