| Doctor Name: | RAYMOND COSTA |
| NPI Number: | 1093083149 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | 37PC00394900 |
| Business Practice Address: | 4122 Route 516 Suite C And D Matawan, NJ - 077477022 |
| Business Phone Number: | 7326794500 |
| Business Fax Number: | 7326794549 |
| Mailing Address: | 4122 Route 516, Suite C And D MATAWAN |
| State: | NJ |
| Postal Code: | 077477022 |
| Phone Number: | 7326794500 |
| Fax Number: | 7326794549 |
| NPI Enumeration Date: | 12/05/2011 |
| NPI Last Update Date: | 12/05/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 37PC00394900 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NJ |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |