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Mr. Raymond Richard Pettis, MS,LMHC
Mental Health Counselor in Waterloo, New York
NPI 1073620753

Raymond Richard Pettis is a Mental Health Counselor based in Waterloo, NY and is specialized in Mental Health. Raymond Richard Pettis practices in Waterloo, NY and has the professional credentials of MS,LMHC. The NPI Number for Raymond Richard Pettis is 1073620753 and holds a License No. 001185 (New York).

The current practice location address for Raymond Richard Pettis is 31 Thurber Dr, Waterloo, NY and can be reached out via phone at 315-539-1980 and via fax at 315-539-1054.

Location: 31 Thurber Dr, Waterloo, NY, 13165-1600
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1073620753
Provider Name
Raymond Richard Pettis
Credential
MS,LMHC
Provider Entity Type
Individual
Gender
Male
Address
31 Thurber Dr, Waterloo, NY, 13165-1600
Phone Number
315-539-1980
Fax Number
315-539-1054
Provider Enumeration Date
08/25/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
001185 05 NY
institution
Provider Business Practice Location Address Details
Address
31 Thurber Dr
City
Waterloo
State
New York
Zip
13165-1600
Phone Number
315-539-1980
Fax Number
315-539-1054
person
Provider Business Mailing Address Details
Address
31 Thurber Dr
City
Waterloo
State
New York
Zip
13165-1600
Phone Number
315-539-1980
Fax Number
315-539-1054
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
001185 (New York)
Definition
Definition to come...
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