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General NPI Number Information
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NPI Number | 1124777149
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Entity Type | Individual
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Provider Name | RAYMOND LANDRY LMHC, LADC1
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Gender | Male
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Dates
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Enumeration Date | 03/18/2022
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 50 UNION ST
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City | WEST SPRINGFIELD
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State | MA
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Zip | 01089-3317
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Country | US
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Telephone | 413-734-0040
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 317
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City | BELCHERTOWN
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State | MA
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Zip | 01007-0317
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Country | US
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Telephone | 413-362-9855
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 20981
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LMHC10003509
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License Number State | MA
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