Individual provider Active NPI

Connie M Ray, LPC

  • Counselor
  • Heavener, OK
National Provider Identifier
1154608164
Registry record updated Apr 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
123 E Avenue C Ste B
Heavener, OK 74937-2603
Phone
(918) 658-4016
Fax
(866) 318-8057
NPI assigned
Nov 5, 2011
Last updated
Apr 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1302 OK
Mental Health Counselor 101YM0800X
Mental Health Counselor 101YM0800X 6213 OK

Addresses

Primary practice location

123 E Avenue C Ste B
Heavener, OK 74937-2603

Mailing address

123 E Avenue C
Heavener, OK 74937-2603
Phone (918) 658-4016

Other identifiers 1

IdentifierTypeStateIssuer
1154608164MedicaidOK

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
I20240216003520 OK Practitioner - Mental Health Counselor 9133563281 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
A Counseling, IncGroup PAC ID 1355785494, 2 clinicians

Practice addresses (Care Compare)

123 E Ave C
Heavener, OK 74937-2603
Phone (918) 653-2543

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1302OKMDHealth Service Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
A Plus Care Program LLC Counselor CurrentSince Sep 20, 2020 Accepting new patients
A Counseling, Inc Addiction (Substance Use Disorder) CurrentSince Jan 23, 2024 Accepting new patients

Locations

123 E Avenue C
Heavener, OK 74937
Phone (918) 653-2543

123 E Avenue C
Ste B
Heavener, OK 74937
Phone (918) 653-2543

309 Rogers Ave
Poteau, OK 74953
Phone (918) 647-5395

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1320451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776211200000",
    "number": "1154608164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 E AVENUE C",
            "city": "HEAVENER",
            "state": "OK",
            "postal_code": "749372603",
            "telephone_number": "918-658-4016",
            "fax_number": "866-318-8057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 E AVENUE C STE B",
            "city": "HEAVENER",
            "state": "OK",
            "postal_code": "749372603",
            "telephone_number": "918-658-4016",
            "fax_number": "866-318-8057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "CONNIE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-05",
        "last_updated": "2026-04-15",
        "certification_date": "2026-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OK",
            "license": "1302",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "6213",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154608164",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Heavener, OK

Sources for this page

Verify at the official NPI Registry.