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General NPI Number Information
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NPI Number | 1437758257
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Entity Type | Individual
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Provider Name | ROBERT CARSON RAYMOND
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Gender | Male
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Dates
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Enumeration Date | 10/22/2020
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Last Update Date | 09/03/2024
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Provider Practice Location Address
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Address Line | 2488 E 81ST ST STE 4821
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City | TULSA
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State | OK
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Zip | 74137-4290
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Country | US
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Telephone | 918-236-0833
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Fax |
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Provider Business Mailing Address
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Address Line | 2834 E 90TH ST UNIT 1806
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City | TULSA
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State | OK
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Zip | 74137-3377
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Country | US
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Telephone | 734-646-4354
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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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 | 10390
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License Number State | OK
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