# RAYMOND F GANNON

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

## Provider details

- **NPI number:** 1831374008
- **Gender:** Man
- **Credential:** LMHC, LPC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | MH12846 | FL | Yes |
| 101YP2500X | Professional Counselor | 37PC00364400 | NJ | — |

## Other

- **Enumeration date:** 01/07/2008
- **Last updated:** 05/09/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0029807 | — | NJ |
| 01 | — | 526788 | MEDICARE GROUP \# | NJ |