Individual provider Active NPI

Arlie A Ray Jr., LPCC

  • Mental Health Counselor
  • Springfield, OH
National Provider Identifier
1639672041
Registry record updated Jan 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.2202760 Issued in OH
Practice address
363 S Burnett Rd Ste 2
Springfield, OH 45505-2628
Phone
(937) 502-1333
Fax
(937) 502-1334
NPI assigned
Mar 12, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2024

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 E.2202760 OH Primary

Addresses

Primary practice location

363 S Burnett Rd Ste 2
Springfield, OH 45505-2628

Mailing address

1919 Kimberly Cir
Springfield, OH 45503-6443
Phone (937) 207-1153

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20240419002499 OH Practitioner - Mental Health Counselor 3971942111 Practice locations: Springfield, OH

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1919 Kimberly Cir
Springfield, OH 45503-6443

363 S Burnett Rd
Suite 2
Springfield, OH 45505-2628
Phone (937) 502-1333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.2202760OHMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1520812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706227200000",
    "number": "1639672041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 KIMBERLY CIR",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455036443",
            "telephone_number": "937-207-1153",
            "fax_number": "937-502-1334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 S BURNETT RD STE 2",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455052628",
            "telephone_number": "937-502-1333",
            "fax_number": "937-502-1334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "ARLIE",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-12",
        "last_updated": "2024-01-26",
        "certification_date": "2024-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2202760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.