Mary C Ray, LADAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

0158531 Issued in NM

Practice address

4001 Office Court Dr Ste 102
Santa Fe, NM 87507-4903

Phone

(505) 983-8225

Fax

(505) 930-5427

NPI assigned

Aug 19, 2019

Last updated

Aug 19, 2019By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Earth Spirit Awakenings LLC

  dba Mesa Vista Wellness

  • Community/Behavioral Health Agency
  • Santa Fe, NM
  • NPI 1447490800
  NPD

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

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566172800000",
    "number": "1649827395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 OFFICE COURT DR STE 102",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875074903",
            "telephone_number": "505-983-8225",
            "fax_number": "505-930-5427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 OFFICE COURT DR STE 102",
            "city": "SANTA FE",
            "state": "NM",
            "postal_code": "875074903",
            "telephone_number": "505-983-8225",
            "fax_number": "505-930-5427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "MARY",
        "middle_name": "C",
        "credential": "LADAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-19",
        "last_updated": "2019-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "0158531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yvette Rascon
• Mary Raske
• Mark Alan Rasmussen, O.D.
• Annie J Rasquin, LISW
• Daina Rasutis
• Erin Bonham Rayburn, PA-C
• Larry Alan Rayburn, M.A.
• Raymond Singer, PH.D., P.a.
• Randi Raymond, IMD
• Anna Rayne-Levi, LPCC

• Addiction (Substance Use Disorder) Counselor in Santa Fe, NM
• Providers in Santa Fe, NM by specialty
• Addiction (Substance Use Disorder) Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2019; 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.