Cammack, Ray Edward

Cammack, Ray Edward is an sole proprietor health care provider with primary practice located at 5420 W Franklin Rd , Boise ID 83705-1071. He recently has 3 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center), Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Cammack, Ray Edward can be contacted via phone (208) 420-5380.

Contact Information

Primary practice address
5420 W Franklin Rd Boise ID 83705-1071
Phone: (208) 420-5380
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X LCPC-3129 Idaho
Behavioral Health & Social Service Providers / Professional 101YP2500X LCPC-3129 Idaho
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LCPC-3129 Idaho

Profile Details

NPI number 1528055399
LBN Legal business name Cammack, Ray Edward
Credentials M. ED., LCPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 5th, 2005
Last updated Dec 10th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1528055399 NPPES
Idaho MEDICAID 1861500035

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