Ray Fearon

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PC011400 Issued in PA

Practice address

29 Northumberland Dr
Eastampton, NJ 08060-3298

Phone

(096) 510-1012

NPI assigned

Jun 11, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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.

• Thriving Minds Therapy LLC

  • Professional Counselor
  • Eastampton, NJ
  • NPI 1508597774
  NPD Authorized official
• Heather C Pinto PSYD LLC

  dba Renewed Hope Family Services

  • Psychologist
  • Newtown, PA
  • NPI 1083030746
  NPD (past)

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

{
    "created_epoch": "1560211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1447819610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 NORTHUMBERLAND DR",
            "city": "EASTAMPTON",
            "state": "NJ",
            "postal_code": "080603298",
            "telephone_number": "096-510-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 NORTHUMBERLAND DR",
            "city": "EASTAMPTON",
            "state": "NJ",
            "postal_code": "080603298",
            "telephone_number": "096-510-1012"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "790 Newtown Yardley Rd Ste 422",
            "address_purpose": "LOCATION",
            "city": "Newtown",
            "state": "PA",
            "postal_code": "189404503",
            "country_code": "US",
            "telephone_number": "215-579-2180",
            "fax_number": "215-579-2060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEARON",
        "first_name": "RAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-11",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37PC00821000",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC011400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LPC LICENSE",
            "identifier": "PC011400",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eastampton TWP. Board of Education
• Matthew Clinton Edson, DVM
• Tracey ENT
• Hollis Allen Evans, MSW, LCSW
• Evergreen Healthcare Services LLC
• Carla Lee Fynan, R.D.
• Miranda Kaleigh Gable
• Mary Hill
• Hope Family Therapy and Consultation Services, LLC
• Tyler Hullings

• Mental Health Counselor in Eastampton, NJ
• Providers in Eastampton, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; 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.