Individual provider Active NPI

Denise Ray

  • Clinical Social Worker
  • Bala Cynwyd, PA
National Provider Identifier
1396251906
Registry record updated Jan 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW005909E Issued in PA
Practice address
111 Presidential Blvd
East Lobby Suite 237
Bala Cynwyd, PA 19004-1012
Phone
(610) 772-3939
Fax
(215) 877-3529
NPI assigned
Dec 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW005909E PA Primary

Addresses

Primary practice location

111 Presidential Blvd
East Lobby Suite 237
Bala Cynwyd, PA 19004-1012

Mailing address

5745 Woodbine Ave
Philadelphia, PA 19131-1236
Phone (215) 983-1488

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW005909EPAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A New Spirit Behavioral Health Services, LLC Current Accepting new patients

Locations

111 Presidential Blvd
Ste 237
Bala Cynwyd, PA 19004
Phone (215) 849-8133

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515542400000",
    "number": "1396251906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5745 WOODBINE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191311236",
            "telephone_number": "215-983-1488",
            "fax_number": "215-877-3529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 PRESIDENTIAL BLVD",
            "address_2": "EAST LOBBY SUITE 237",
            "city": "BALA CYNWYD",
            "state": "PA",
            "postal_code": "190041012",
            "telephone_number": "610-772-3939",
            "fax_number": "215-877-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "DENISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-18",
        "last_updated": "2018-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "SW005909E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bala Cynwyd, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2018; 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.