Provider Demographics
NPI:1861419806
Name:SCAMPINI, RAYMOND SCOTT (LCSW)
Entity type:Individual
Prefix:MR
First Name:RAYMOND
Middle Name:SCOTT
Last Name:SCAMPINI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2021 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97403-2043
Mailing Address - Country:US
Mailing Address - Phone:541-905-1897
Mailing Address - Fax:541-440-1374
Practice Address - Street 1:211 E 7TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-2773
Practice Address - Country:US
Practice Address - Phone:541-242-0453
Practice Address - Fax:541-265-6602
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2016-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL30931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORL3093OtherLCSW