Raymond B. Long, BA
Individual provider Active NPI Pastoral Counselor · Dilkon, AZ
NPI 1336701127 · NPPES record last updated Jul 2, 2019
Key facts
- NPI
- 1336701127
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pastoral Counselor 101YP1600X
- Practice address
- Northeast of Bashas'
Dilkon, AZ 86047 - Phone
- (928) 657-8000
- NPI assigned
- Jul 2, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Bachelor of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dilkon Outpatient Treatment Center | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | Yes |
Addresses
Primary practice location
Northeast of Bashas'
Dilkon, AZ 86047
Mailing address
PO Box 7072
Winslow, AZ 86047-7072
Phone (928) 657-8000
Other providers in Dilkon, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2019. 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.