Individual provider Active NPI

Jeremy Jason Ray

  • Clinical Social Worker
  • Greenville, SC
National Provider Identifier
1174089254
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
16434 Issued in SC
Practice address
68 Pointe Cir
Greenville, SC 29615-6330
Phone
(864) 832-2296
NPI assigned
Feb 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 16434 SC Primary

Addresses

Primary practice location

68 Pointe Cir
Greenville, SC 29615-6330

Mailing address

68 Pointe Cir
Greenville, SC 29615-6330
Phone (864) 832-2296

Other practice location 1

309 E Main St
Pickens, SC 29671-2319
Phone (864) 898-5800

Other practice location 2

309 E Main St
Pickens, SC 29671-2319
Phone (864) 898-5800

Other practice location 3

309 E Main St
Pickens, SC 29671-2319
Phone (330) 639-5336 ext. 33063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20240216001711 SC Practitioner - Clinical Social Worker 5496199598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of South Carolina School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

68 Pointe Cir
Suite 3201
Greenville, SC 29615-6307
Phone (864) 479-1212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16434SCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Revive Counseling Professionals LLC Clinical Current Accepting new patients
Thrive Counseling LLC Mental Health CurrentSince Nov 9, 2023 Accepting new patients
Pickens County Commission on Alcohol & Drug Abuse Past Accepting new patients
Pickens County Commission on Alcohol & Drug Abuse PastSince Apr 28, 2024 Accepting new patients

Locations

68 Pointe Cir
Ste 3201
Greenville, SC 29615
Phone (864) 479-1212

4975 Lacross Rd
Ste 351
North Charleston, SC 29406
Phone (800) 309-1159

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

Organizations & group practices 4

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": "1550102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1174089254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 POINTE CIR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156330",
            "telephone_number": "864-832-2296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 POINTE CIR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156330",
            "telephone_number": "864-832-2296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 E Main St",
            "address_purpose": "LOCATION",
            "city": "Pickens",
            "state": "SC",
            "postal_code": "296712319",
            "country_code": "US",
            "telephone_number": "864-898-5800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 E Main St",
            "address_purpose": "LOCATION",
            "city": "Pickens",
            "state": "SC",
            "postal_code": "296712319",
            "country_code": "US",
            "telephone_number": "864-898-5800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 E Main St",
            "address_purpose": "LOCATION",
            "city": "Pickens",
            "state": "SC",
            "postal_code": "296712319",
            "country_code": "US",
            "telephone_number": "330-639-5336 x33063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAY",
        "first_name": "JEREMY",
        "middle_name": "JASON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-14",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "16434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.