Provider Demographics
NPI:1497837736
Name:DUCHETTE, RAYMOND FERNARD (LCSW)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:FERNARD
Last Name:DUCHETTE
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:RAYMOND DUCHETTE
Mailing Address - Street 2:443 MAIN ST
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-6733
Mailing Address - Country:US
Mailing Address - Phone:207-240-3571
Mailing Address - Fax:207-783-0500
Practice Address - Street 1:443 MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6733
Practice Address - Country:US
Practice Address - Phone:207-240-3571
Practice Address - Fax:207-783-0500
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC4901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA098219OtherANTHAM BCBS
MA098219OtherANTHAM BCBS