Individual provider Active NPI

Kelly S. Wray, LADC CANDIDATE

  • Addiction (Substance Use Disorder) Counselor
  • Norman, OK
National Provider Identifier
1013291525
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
15951 Little Axe Dr
Norman, OK 73026-9088
Phone
(405) 447-0300
NPI assigned
Oct 3, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

15951 Little Axe Dr
Norman, OK 73026-9088

Mailing address

15951 Little Axe Dr
Norman, OK 73026-9088
Phone (405) 447-0300

Other practice location 1

2029 Gordon Cooper Dr
Shawnee, OK 74801-9005
Phone (405) 878-5850

Other practice location 2

15702 E State Highway 9
Norman, OK 73026-9028
Phone (405) 447-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251218001189 OK Practitioner - Mental Health Counselor 6608361506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

15951 Little Axe Dr
Norman, OK 73026-9088
Phone (405) 447-0300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1211OKMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Absentee Shawnee Tribal Health Authority, Inc. CurrentSince Oct 3, 2025 Accepting new patients
Absentee Shawnee Tribal Health Authority, Inc. CurrentSince Oct 3, 2025 Accepting new patients

Locations

15951 Little Axe Dr
Norman, OK 73026
Phone (405) 447-0300

15702 E State Highway 9
Norman, OK 73026
Phone (405) 447-0300

2029 Gordon Cooper Dr
Shawnee, OK 74801
Phone (405) 878-4702

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1013291525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15951 LITTLE AXE DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730269088",
            "telephone_number": "405-447-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15951 LITTLE AXE DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730269088",
            "telephone_number": "405-447-0300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2029 Gordon Cooper Dr",
            "address_purpose": "LOCATION",
            "city": "Shawnee",
            "state": "OK",
            "postal_code": "748019005",
            "country_code": "US",
            "telephone_number": "405-878-5850",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15702 E State Highway 9",
            "address_purpose": "LOCATION",
            "city": "Norman",
            "state": "OK",
            "postal_code": "730269028",
            "country_code": "US",
            "telephone_number": "405-447-0300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WRAY",
        "first_name": "KELLY",
        "middle_name": "S.",
        "name_prefix": "Mr.",
        "credential": "LADC CANDIDATE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-03",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.