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MR. RAYMOND RICHARD PETTIS MS, LMHC
NPI 1073620753
Counselor - Mental Health in Waterloo, NY

Active since August 25, 2006
31 THURBER DR, WATERLOO, NY 13165(315) 539-1980(315) 539-1054 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mr. Raymond Richard Pettis Ms, Lmhc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. RAYMOND RICHARD PETTIS MS, LMHC (NPI 1073620753) is an individual mental health provider in Waterloo, New York, licensed in New York (001185) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1073620753
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMR. RAYMOND RICHARD PETTISCredential: MS, LMHC
Location Address31 THURBER DRWaterloo, NY 13165-1600
Mailing Address31 Thurber DrWaterloo, NY 13165-1600 · (315) 539-1980 · Fax (315) 539-1054
Phone(315) 539-1980
Fax(315) 539-1054
Sole ProprietorNo
Enumeration DateAugust 25, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1073620753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NY · 001185
31 THURBER DR, Waterloo, NY 13165
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Other Identifiers 1

Medicaid001185NY

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAREN ALICE BRIGHAM
Case Manager/Care Coordinator
31 THURBER DR
WATERLOO, NY 13165
Seneca County (315) 539-1922
SANDRA J DONLON-LANDSCHOOT RN
Registered Nurse
31 THURBER DR, SUITE 1
WATERLOO, NY 13165
Seneca County (315) 539-1929
EUGENE STOREY JR.
Peer Specialist
31 THURBER DR
WATERLOO, NY 13165
Seneca County (315) 539-1980
MS. MARY P GRACE LCSW, CASAC, CPP
Social Worker (Clinical)
31 THURBER DR
WATERLOO, NY 13165
Seneca County (315) 539-1985
DAVID P LEE LMSW
Social Worker
31 THURBER DR
WATERLOO, NY 13165
Seneca County (315) 539-1985
STACEY LYNN FEGLEY RN, BSN
Registered Nurse
31 THURBER DR
WATERLOO, NY 13165
Seneca County (315) 539-1929
CYNTHIA EILEEN MECKLEY RN
Registered Nurse
31 THURBER DR
WATERLOO, NY 13165
Seneca County (315) 539-1980
ROBERT SHIELDS CRPA-P
Peer Specialist
31 THURBER DR
WATERLOO, NY 13165
Seneca County (315) 539-1985

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Raymond Pettis's NPI number?

The NPI number for Raymond Pettis is 1073620753. It was assigned to this individual provider in the NPPES registry on August 25, 2006.

Where is Raymond Pettis located?

Raymond Pettis practices at 31 Thurber Dr, Waterloo, NY 13165. The listed phone number is (315) 539-1980.

What is Raymond Pettis's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Raymond Pettis was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.