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Individual

MR. RAY EDWARD CAMMACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M. ED., LCPC

Contact information

Practice address
1835 S MARSH WOOD PL, MERIDIAN, ID 83642-7457
(208) 420-5380
Mailing address
1835 S MARSH WOOD PL, MERIDIAN, ID 83642-7457
(208) 420-5380

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LCPC-3129
ID
101YP2500X
Professional Counselor
LCPC-3129
ID
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
LCPC-3129
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1861500035
ID
Enumeration date
10/05/2005
Last updated
03/23/2026
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