Ray, Connie M

Ray, Connie M is an sole proprietor health care provider with primary practice located at 123 E Avenue C Ste B , Heavener OK 74937-2603. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Ray, Connie M can be contacted via phone (918) 658-4016.

Contact Information

Primary practice address
123 E Avenue C Ste B Heavener OK 74937-2603
Phone: (918) 658-4016
Fax: (866) 318-8057
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1302 Oklahoma
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 6213 Oklahoma

Profile Details

NPI number 1154608164
LBN Legal business name Ray, Connie M
Credentials LPC CANDIDATE
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 5th, 2011
Last updated Sep 16th, 2020 - about 4 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 1154608164 NPPES
Oklahoma MEDICAID 1154608164

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