Re'Quavas Jacqui Wray

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A22107 Issued in NC

Practice address

809 N Lafayette St Ste a
Shelby, NC 28150-3886

Phone

(704) 284-0554

NPI assigned

May 27, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Creek Consulting

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shelby, NC
  • NPI 1750223194
  NPD Authorized official
• Happy Hour Counseling Center PLLC

  • Marriage & Family Therapist
  • Shelby, NC
  • NPI 1831823467
  NPD (past)

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

{
    "created_epoch": "1748304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1295528727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 S DEKALB ST APT 1011",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281527685",
            "telephone_number": "704-466-9257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "809 N LAFAYETTE ST STE A",
            "city": "SHELBY",
            "state": "NC",
            "postal_code": "281503886",
            "telephone_number": "704-284-0554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 N Lafayette St",
            "address_purpose": "LOCATION",
            "city": "Shelby",
            "state": "NC",
            "postal_code": "281504445",
            "country_code": "US",
            "telephone_number": "980-202-0434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WRAY",
        "first_name": "RE'QUAVAS",
        "middle_name": "JACQUI",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-27",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A22107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wood SLP Services, Inc.
• Judah Benjamin Woodall
• Richard Mark Woodall, CPHT-ADV
• Amanda Freeman Wortman, MA
• Madeline Haley Wray
• Terry Key Wray
• Brook Lyn Wright, FNP
• Justen Daniel Wright, PA-C
• Susan C Wright, LCSW
• Pamella Machado Yamada, MD

• Mental Health Counselor in Shelby, NC
• Providers in Shelby, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.