Individual provider · Type 1 NPI

Raven Wilson

Mental Health Counselor · Plattsburgh, NY

NPI number 1740725050 Active

Practice location

80 Sharron Ave
Plattsburgh, NY 12901-4700

Call (518) 561-1447 Map

Fax (518) 562-8812

Mailing address

79 Glenridge Rd
Glenville, NY 12302-4523

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800X010789 (NY)
Addiction (Substance Use Disorder) Counselor 101YA0400X33417 (NY)

Mental Health Counselor: Definition to come...

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About NPI 1740725050

Raven Wilson's National Provider Identifier is 1740725050, issued on Dec 21, 2016. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Plattsburgh, NY. The record was last updated on Jan 12, 2021.