Provider Demographics
NPI:1427673987
Name:RAIMONDO, CARRIE SUSANNE (MS, NCC, LPC, LMHC)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:SUSANNE
Last Name:RAIMONDO
Suffix:
Gender:F
Credentials:MS, NCC, LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4555 DEANNA CT
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-1560
Mailing Address - Country:US
Mailing Address - Phone:207-831-9355
Mailing Address - Fax:
Practice Address - Street 1:19 GROVE AVE
Practice Address - Street 2:
Practice Address - City:WESTERLY
Practice Address - State:RI
Practice Address - Zip Code:02891-1824
Practice Address - Country:US
Practice Address - Phone:401-932-2045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-10
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH23386101YM0800X
RIMHC01579101YM0800X
CT5114101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional