Provider Demographics
NPI:1558375154
Name:RAICHIE, DEBRA (LCDP)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:RAICHIE
Suffix:
Gender:F
Credentials:LCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 ELMWOOD AVENUE
Mailing Address - Street 2:BRIDGEMARK
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888
Mailing Address - Country:US
Mailing Address - Phone:401-781-2700
Mailing Address - Fax:
Practice Address - Street 1:2020 ELMWOOD AVENUE
Practice Address - Street 2:BRIDGEMARK
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02888
Practice Address - Country:US
Practice Address - Phone:401-781-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)