# RAYMOND SAMUEL WAGSTAFF

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1710287842
- **Gender:** Man

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | 8099256-6004 | UT | Yes |
| 101YP2500X | Professional Counselor | — | NULL | — |

## Other

- **Enumeration date:** 10/22/2010
- **Last updated:** 06/30/2026