Individual provider Active NPI

Tammy L. Ray, LCSW

  • Mental Health Counselor
  • Tillamook, OR
National Provider Identifier
1306020771
Registry record updated Oct 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
906 Main Ave
Tillamook, OR 97141
Phone
(503) 842-8201
Fax
(503) 815-1870
NPI assigned
Dec 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2011

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

Specialties & licenses 2

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

Addresses

Primary practice location

906 Main Ave
Tillamook, OR 97141

Mailing address

906 Main Ave
Tillamook, OR 97141
Phone (503) 842-8201

Other identifiers 1

IdentifierTypeStateIssuer
197749MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20120209000557 OR Practitioner - Clinical Social Worker 1153588744 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Columbia Lutheran CharitiesGroup PAC ID 5294643359, shared by 8 NPIs, 110 clinicians

Practice addresses (Care Compare)

1639 SE Ensign LN
Suite B103
Warrenton, OR 97146-7308
Phone (503) 338-4500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Lutheran Charities CurrentSince Apr 2, 2018 Accepting new patients
Columbia Lutheran Charities CurrentSince Apr 2, 2018 Accepting new patients
Columbia Lutheran Charities Past Accepting new patients
Columbia Lutheran Charities Past Accepting new patients
Tillamook Family Counseling Center PastSince Feb 6, 2017 Accepting new patients

Locations

2111 Exchange St
Astoria, OR 97103
Phone (503) 325-4321

1639 SE Ensign Ln
Ste B103
Warrenton, OR 97146
Phone (503) 338-4500

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/tfcc/r4/

Organizations & group practices 5

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": "1198108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318377600000",
    "number": "1306020771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 MAIN AVE",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "97141",
            "telephone_number": "503-842-8201",
            "fax_number": "503-815-1870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 MAIN AVE",
            "city": "TILLAMOOK",
            "state": "OR",
            "postal_code": "97141",
            "telephone_number": "503-842-8201",
            "fax_number": "503-815-1870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "TAMMY",
        "middle_name": "L.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-20",
        "last_updated": "2011-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197749",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tillamook, OR

Sources for this page

Verify at the official NPI Registry.