Provider Demographics
NPI:1831240621
Name:RAYMOND, DAVID EUGENE (LCSW)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:EUGENE
Last Name:RAYMOND
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 1:3608 LANCASTER PIKE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-1509
Mailing Address - Country:US
Mailing Address - Phone:302-995-9600
Mailing Address - Fax:302-995-9571
Practice Address - Street 1:3608 LANCASTER PIKE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-1509
Practice Address - Country:US
Practice Address - Phone:302-995-9600
Practice Address - Fax:302-995-9571
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00002671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE646042Medicare ID - Type Unspecified