Jean-Raphael De Raoulx, LPC #2556
Individual provider Active NPI Mental Health Counselor · Gillette, WY
NPI 1003500869 · NPPES record last updated May 22, 2026
Key facts
- NPI
- 1003500869
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- LPC-2556 (WY)
- Practice address
- 100 Warren Ave
Gillette, WY 82716-3728 - Phone
- (307) 682-2034
- NPI assigned
- Jun 5, 2023
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-2556 | WY | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC-2556 | WY | Yes |
Addresses
Primary practice location
100 Warren Ave
Gillette, WY 82716-3728
Mailing address
555 S Main St
Buffalo, WY 82834-2114
Other providers in Gillette, WY
- Davis Outpatient Therapy LLC
- Bethany Davis
- Cameron Wayne Davis
- Thomas Clifford Davis
- Nancy Day
- Paul D Dearing
- Chrissy Michael Deavor
- Laurence William Vale Deboer
- Britta L Denman
- Dental Care Center PC
All providers in Gillette, WY · Mental Health Counselor in Wyoming
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.