Individual
RAYMOND MICHAEL GILLETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW, LAC, MDIV
Contact information
Practice address
7308 W HALE ST, WICHITA, KS 67212-3141
(860) 428-9547
Mailing address
7308 W HALE ST, WICHITA, KS 67212-3141
(860) 428-9547
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
4877
KS
101YA0400X
Addiction (Substance Use Disorder) Counselor
001
KS
101YM0800X
Mental Health Counselor
4877
KS
101YP1600X
Pastoral Counselor
—
—
104100000X
Social Worker
4877
KS
1041C0700X
Clinical Social Worker
Primary
4877
KS
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
10/09/2015
Last updated
03/19/2019
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