Provider Demographics
NPI:1942366364
Name:RAAB AND ASSOCIATES, INC
Entity Type:Organization
Organization Name:RAAB AND ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:E
Authorized Official - Last Name:RAAB
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:586-295-0007
Mailing Address - Street 1:25490 LITTLE MACK
Mailing Address - Street 2:
Mailing Address - City:ST. CLAIR SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:48081-2157
Mailing Address - Country:US
Mailing Address - Phone:586-779-8003
Mailing Address - Fax:586-779-8146
Practice Address - Street 1:25490 LITTLE MACK
Practice Address - Street 2:
Practice Address - City:ST. CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-2157
Practice Address - Country:US
Practice Address - Phone:586-779-8003
Practice Address - Fax:586-779-8146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010163931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOPO8520Medicare PIN
MI4464Medicare UPIN
MIPO852OO1Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE NUMBE