Individual provider · Type 1 NPI
Ray Ali Tebout, CASAC
Addiction (Substance Use Disorder) Counselor · Long Island City, NY
NPI number
1194992867
Active
Practice location
2976 Northern Blvd
Long Island City, NY 11101-2822
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | None listed |
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 26665 (NY) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1194992867
Ray Ali Tebout, CASAC's National Provider Identifier is 1194992867, issued on May 13, 2008. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Long Island City, NY. The record was last updated on Jan 16, 2012.