Provider Demographics
NPI:1912152109
Name:WOJCIECHOWSKI, RAYMOND (LMHC)
Entity Type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:
Last Name:WOJCIECHOWSKI
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 W 61ST PL
Mailing Address - Street 2:
Mailing Address - City:MERRILLVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46410-2327
Mailing Address - Country:US
Mailing Address - Phone:219-980-3802
Mailing Address - Fax:
Practice Address - Street 1:3680 179TH ST
Practice Address - Street 2:SUITE F
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46323-3033
Practice Address - Country:US
Practice Address - Phone:219-670-7180
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39001889A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health