Provider Demographics
NPI:1740354133
Name:MESSER, RAYMOND G (MSW, LISW)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:G
Last Name:MESSER
Suffix:
Gender:M
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2555 S DIXIE DR STE 106
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45409-1532
Mailing Address - Country:US
Mailing Address - Phone:937-298-6363
Mailing Address - Fax:937-298-6399
Practice Address - Street 1:2555 S DIXIE DR STE 106
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45409-1532
Practice Address - Country:US
Practice Address - Phone:937-298-6363
Practice Address - Fax:937-298-6399
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI 54241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW147962Medicare ID - Type Unspecified