Individual provider Active NPI

Gypsy S Ray, LCSW

  • Clinical Social Worker
  • Anaconda, MT
National Provider Identifier
1215210851
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
BBH-LCSW-LIC-1013 Issued in MT
Practice address
118 E 7TH St Ste 2D
Anaconda, MT 59711-2913
Phone
(406) 880-0977
NPI assigned
Sep 20, 2011
Last updated
Mar 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1013-LCSW MT
Clinical Social Worker 1041C0700X BBH-LCSW-LIC-1013 MT Primary

Addresses

Primary practice location

118 E 7TH St Ste 2D
Anaconda, MT 59711-2913

Mailing address

88 Lakeshore Dr
Anaconda, MT 59711-9093
Phone (406) 880-0977

Other identifiers 1

IdentifierTypeStateIssuer
0517990MedicaidMT

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://www.psychologytoday.com/us/therapists/mt/anaconda/189050?sid=5c88042686e0a&ref=1&tr=ResultsN Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20190712002594 MT Practitioner - Clinical Social Worker 0244565240 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

18 Cedar St
Anaconda, MT 59711-2308
Phone (406) 880-0977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1013-LCSWMTMDClinical Social Worker
BBH-LCSW-LIC-1013MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gypsy Ray LCSW LLC Clinical CurrentSince Mar 12, 2019 Accepting new patients

Locations

118 E 7th St
Ste 2D
Anaconda, MT 59711
Phone (406) 200-8068

18 Cedar St
Anaconda, MT 59711
Phone (406) 529-1104

Organizations & group practices 1

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": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1215210851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "88 LAKESHORE DR",
            "city": "ANACONDA",
            "state": "MT",
            "postal_code": "597119093",
            "telephone_number": "406-880-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E 7TH ST STE 2D",
            "city": "ANACONDA",
            "state": "MT",
            "postal_code": "597112913",
            "telephone_number": "406-880-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "GYPSY",
        "middle_name": "S",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-20",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "1013-LCSW",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-1013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0517990",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.psychologytoday.com/us/therapists/mt/anaconda/189050?sid=5c88042686e0a&ref=1&tr=ResultsN",
            "affiliation": "N",
            "endpointDescription": "secure website",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "referrals and patient communication",
            "address_1": "118 E 7th St Ste 2D",
            "city": "Anaconda",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597112913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Anaconda, MT

Sources for this page

Verify at the official NPI Registry.