Individual provider Active NPI

Teresa Childres Ray, MA, NCC, LPC

  • Professional Counselor
  • Gastonia, NC
National Provider Identifier
1215914742
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
2295 Issued in NC
Practice address
258 E Garrison Blvd
Gastonia, NC 28054-0460
Phone
(704) 861-8405
Fax
(704) 865-0590
NPI assigned
Dec 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2295 NC Primary

Addresses

Primary practice location

258 E Garrison Blvd
Gastonia, NC 28054-0460

Mailing address

PO Box 3984
Gastonia, NC 28054-0020
Phone (704) 861-8405

Other identifiers 7

IdentifierTypeStateIssuer
B4131OtherNCMEDCOST.DOC ID #
6005064MedicaidNC
0258GOtherNCBCBS GROUP PIN
1039EOtherNCBCBS PROVIDER PIN
6102251MedicaidNC
7433388OtherNCAETNAGROUPBEHPIN
7361114OtherNCAETNA BEH.HEALTH PIN

Other names 1

  • Terri C Ray Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 4, 2024 through May 4, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2295NCMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Gaston Hospice Past Accepting new patients
Hospice of Gaston County, Inc Past Accepting new patients

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": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1215914742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3984",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280540020",
            "telephone_number": "704-861-8405",
            "fax_number": "704-865-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 E GARRISON BLVD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280540460",
            "telephone_number": "704-861-8405",
            "fax_number": "704-865-0590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "TERESA",
        "middle_name": "CHILDRES",
        "credential": "MA, NCC, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "2295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST.DOC ID #",
            "identifier": "B4131",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6005064",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP PIN",
            "identifier": "0258G",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER PIN",
            "identifier": "1039E",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102251",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNAGROUPBEHPIN",
            "identifier": "7433388",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA BEH.HEALTH PIN",
            "identifier": "7361114",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRI",
            "last_name": "RAY",
            "middle_name": "C",
            "credential": "MA, NCC, LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.