Healthcare Provider Details

I. General information

NPI: 1609918986
Provider Name (Legal Business Name): RAYMOND A HOWARD LICSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 93RD STREET
KEENE NH
03431
US

IV. Provider business mailing address

43 KENDALL RD
KEENE NH
03431-2205
US

V. Phone/Fax

Practice location:
  • Phone: 603-283-1679
  • Fax:
Mailing address:
  • Phone: 603-357-4655
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1335
License Number StateNH

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier1335
Identifier TypeOTHER
Identifier StateNH
Identifier IssuerLICSW

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: