Provider Demographics
NPI:1275726481
Name:PARENTI, RAYMOND KARL (LMSW)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:KARL
Last Name:PARENTI
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 ROUTE 25A
Mailing Address - Street 2:SUITE 20
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-2646
Mailing Address - Country:US
Mailing Address - Phone:631-744-5500
Mailing Address - Fax:
Practice Address - Street 1:595 ROUTE 25A
Practice Address - Street 2:SUITE 20
Practice Address - City:MILLER PLACE
Practice Address - State:NY
Practice Address - Zip Code:11764-2646
Practice Address - Country:US
Practice Address - Phone:631-744-5500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071348101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health