Ray, Patricia A

Ray, Patricia A is an individual health care provider with primary practice located at 300 S Broadway Ave Ste 110 A, Urbana IL 61801-3449. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Ray, Patricia A can be contacted via phone (217) 954-1128.

Contact Information

Primary practice address
300 S Broadway Ave Ste 110 A Urbana IL 61801-3449
Phone: (217) 954-1128
Fax: (217) 954-1514
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 14900835 Illinois
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149009355 Illinois

Profile Details

NPI number 1467523118
LBN Legal business name Ray, Patricia A
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 13th, 2006
Last updated Oct 11th, 2019 - about 5 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 1467523118 NPPES
Illinois MEDICAID 203596683001

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