Individual
SAM RAYMOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC, LAC
Contact information
Practice address
1333 IRIS AVE, APT 4, BOULDER, CO 80304-2226
(303) 443-8500
Mailing address
1333 IRIS AVE, APT 4, BOULDER, CO 80304-2226
(303) 443-8500
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ACD.0000469
CO
101YM0800X
Mental Health Counselor
LPC.0011890
CO
Other
Enumeration date
06/28/2015
Last updated
07/31/2017
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