Provider Demographics
NPI:1932961505
Name:TWO RAVENS THERAPY, PLLC
Entity Type:Organization
Organization Name:TWO RAVENS THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMIN, MA, LMFTA
Authorized Official - Phone:919-229-9246
Mailing Address - Street 1:PO BOX 1134
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-1134
Mailing Address - Country:US
Mailing Address - Phone:919-229-9246
Mailing Address - Fax:
Practice Address - Street 1:21 HILLSBORO ST STE 2
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-5936
Practice Address - Country:US
Practice Address - Phone:919-229-9246
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-29
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty