Individual provider Active NPI

Ray Williams

  • Mental Health Counselor
  • Eden Prairie, MN
National Provider Identifier
1619276052
Registry record updated Mar 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
11010 Prairie Lakes Dr
Suite 250
Eden Prairie, MN 55344-3884
Phone
(952) 746-2522
NPI assigned
Mar 24, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

11010 Prairie Lakes Dr
Suite 250
Eden Prairie, MN 55344-3884

Mailing address

1900 Silver Lake Rd NW
Suite 110
New Brighton, MN 55112-1786

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

11990 Portland Ave
Burnsville, MN 55337-1516

6640 Shady Oak Rd
Suite 250D
Eden Prairie, MN 55344-6176

6867 Kingston Dr
Eden Prairie, MN 55346-2909

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1300924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300924800000",
    "number": "1619276052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 SILVER LAKE RD NW",
            "address_2": "SUITE 110",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551121786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11010 PRAIRIE LAKES DR",
            "address_2": "SUITE 250",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443884",
            "telephone_number": "952-746-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "RAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-24",
        "last_updated": "2011-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.