Connie S. Raybuck, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00001628 Issued in WA

Practice address

140 S Arthur St
Suite 415
Spokane, WA 99202-2204

Phone

(509) 535-6386

Fax

(509) 533-0627

NPI assigned

Jun 4, 2006

Sex

Female

Sole proprietor

Yes

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

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Senior Psychology LLC

  • Clinical Psychologist
  • Vancouver, WA
  • NPI 1972730042
  Medicare reassignment

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1306884713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 S ARTHUR ST",
            "address_2": "SUITE 415",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022204",
            "telephone_number": "509-535-6386",
            "fax_number": "509-533-0627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 S ARTHUR ST",
            "address_2": "SUITE 415",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992022204",
            "telephone_number": "509-535-6386",
            "fax_number": "509-533-0627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYBUCK",
        "first_name": "CONNIE",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "PY00001628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie A Ray I, RN00122344
• Kristina Jane Ray, LMHC, CDP
• Matthew S Ray, DO
• Phyllis Ray, LMP
• Terri Ray, BSN, RN
• Melissa Raymond
• Leander Allen Raymont, AAC
• Kassandra Marie Raynor
• Re Anderson Dental Lab
• Brittany Read

• Clinical Psychologist in Spokane, WA
• Providers in Spokane, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.