Provider Demographics
NPI:1730466657
Name:SIZEMORE, RAYMOND OLIVER (LCSW)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:OLIVER
Last Name:SIZEMORE
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 1:2128 HILLARY LN
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:FL
Mailing Address - Zip Code:32566-2838
Mailing Address - Country:US
Mailing Address - Phone:850-699-4899
Mailing Address - Fax:850-939-6237
Practice Address - Street 1:2128 HILLARY LN
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-2838
Practice Address - Country:US
Practice Address - Phone:850-699-4899
Practice Address - Fax:850-939-6237
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-06
Last Update Date:2011-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 101741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical