Healthcare Provider Details

I. General information

NPI: 1649016452
Provider Name (Legal Business Name): RAYMOND Y CAUSEY
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2024
Last Update Date: 07/02/2024
Certification Date: 07/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

480 E UNIVERSITY DR STE 7A
SOMERSET KY
42503-2410
US

IV. Provider business mailing address

PO BOX 2
SOMERSET KY
42502-0002
US

V. Phone/Fax

Practice location:
  • Phone: 606-451-9379
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number293135
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: