Provider Demographics
NPI:1992551626
Name:GUIDA, RAYMOND DOMINICK (LMSW)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:DOMINICK
Last Name:GUIDA
Suffix:
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 1:129 W ROGUES PATH
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-5025
Mailing Address - Country:US
Mailing Address - Phone:631-294-4232
Mailing Address - Fax:
Practice Address - Street 1:129 W ROGUES PATH
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-5025
Practice Address - Country:US
Practice Address - Phone:631-294-4232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-24
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY074880-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker