Provider Demographics
NPI:1962868257
Name:GEORGE, RAYMOND CHARLES JR (LPC)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:CHARLES
Last Name:GEORGE
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3323
Mailing Address - Country:US
Mailing Address - Phone:814-421-5715
Mailing Address - Fax:
Practice Address - Street 1:1200 ASHWOOD DR
Practice Address - Street 2:SUITE 1201
Practice Address - City:CANONSBURG
Practice Address - State:PA
Practice Address - Zip Code:15317-4982
Practice Address - Country:US
Practice Address - Phone:724-884-0466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-03
Last Update Date:2016-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC008613101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional