Provider Demographics
NPI:1972374833
Name:DEMERS, RAYMOND MICHAEL JR (LMSW)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:MICHAEL
Last Name:DEMERS
Suffix:JR
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 ORANGE ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-2014
Mailing Address - Country:US
Mailing Address - Phone:203-937-2309
Mailing Address - Fax:
Practice Address - Street 1:15 WOODSIDE CIR
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:CT
Practice Address - Zip Code:06798-1528
Practice Address - Country:US
Practice Address - Phone:203-937-2309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6753104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker