Melissa Lyn Ray, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

72279 Issued in TX

Practice address

510 E Commerce St
Jacksonville, TX 75766-4910

Phone

(903) 535-9041

Fax

(903) 586-0001

NPI assigned

Sep 6, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Melissa Lyn Hefner Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Mental Health Counselor

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tyler Family Circle of CareGroup PAC ID 4587812888, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Tyler Family Circle of Care

  • Federally Qualified Health Center (FQHC)
  • Tyler, TX
  • NPI 1144575820
  Medicare reassignment Care Compare group NPD
• Tyler Family Circle of Care

  • Community/Retail Pharmacy
  • Tyler, TX
  • NPI 1942011903
  NPD

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

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1447971676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 S FANNIN AVE",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757028204",
            "telephone_number": "903-535-9041",
            "fax_number": "903-586-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E COMMERCE ST",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757664910",
            "telephone_number": "903-535-9041",
            "fax_number": "903-586-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "MELISSA",
        "middle_name": "LYN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-06",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "72279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MELISSA",
            "last_name": "HEFNER",
            "middle_name": "LYN",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• QV Urgent Care TX PLLC
• Mark Christopher Race, MD
• Radiology & Diagnostic Services
• Clair Johanna Radliff
• Jane Ragland, MD
• RCG East Texas, LLP
• David Rentz
• Jackie Rentz, COTA
• Michelle Rhodes, LMSW
• Kaila Sue Rice, LPCI

• Mental Health Counselor in Jacksonville, TX
• Providers in Jacksonville, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.