Jeremiah Gregory Raymo, LCSW
Individual provider Active NPI Clinical Social Worker · McConnell Afb, KS
NPI 1972904597 · NPPES record last updated Aug 10, 2022
Key facts
- NPI
- 1972904597
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 134998 (AK)
- Practice address
- 57950 Leavenworth St
McConnell Afb, KS 67221-3505 - Phone
- (316) 759-5095
- NPI assigned
- Sep 15, 2014
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 134998 | AK | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Sedgwick | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 134998 | AK | Yes |
Addresses
Primary practice location
57950 Leavenworth St
McConnell Afb, KS 67221-3505
Mailing address
57950 Leavenworth St
McConnell Afb, KS 67221-3505
Phone (316) 759-5095
Other providers in McConnell Afb, KS
- Harmony Osborn
- Thoa Ngoc Pham
- Allen Lee Plangklang
- Brooke Elizabeth Prine
- Timothy Rafferty
- Levi Josiah Rickards
- Richard Jimenez Rubi
- Jessica Rynders
- Rose Lee Samples
- Jenna Lynn Scholl
All providers in McConnell Afb, KS · Clinical Social Worker in Kansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2022. 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.