Provider Demographics
NPI:1477102218
Name:VELEZ, RAYMOND (LCSW)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:VELEZ
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 WILLOWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-1216
Mailing Address - Country:US
Mailing Address - Phone:516-435-7849
Mailing Address - Fax:
Practice Address - Street 1:2174 HEWLETT AVE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3606
Practice Address - Country:US
Practice Address - Phone:515-721-7694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-04
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076914104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker