Van David Ray, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C003722 Issued in NC

Practice address

115 E Main St
1St Floor Office 1
Williamston, NC 27892-2492

Phone

(252) 792-1626

Fax

(252) 792-1658

NPI assigned

May 22, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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.

• U-Turn Human Services, Inc.

  • Community/Behavioral Health Agency
  • Williamston, NC
  • NPI 1467620211
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241049600000",
    "number": "1659580132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 SYME CIR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278589765",
            "telephone_number": "252-757-2465",
            "fax_number": "252-792-1658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 E MAIN ST",
            "address_2": "1ST FLOOR OFFICE 1",
            "city": "WILLIAMSTON",
            "state": "NC",
            "postal_code": "278922492",
            "telephone_number": "252-792-1626",
            "fax_number": "252-792-1658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "VAN",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2009-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C003722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF NC",
            "identifier": "139AX",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6003204",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Providence Rehabilitation and Hospice Services
• Shana B Putnam, CRT, RCP
• QFM Enterprise LLC
• R and R Elite Enterprises LLC
• R.E.a.L.I.T.Y. Counseling and Consulting, LLC
• Respiratory Consulting Services, Inc
• Respiratory Health Services &Associates
• Gwendolyn Flowers Revels, HIS
• Sara Rhoades, FNP
• Fredericka Danielle Rhodes-Godard

• Clinical Social Worker in Williamston, NC
• Providers in Williamston, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2009; 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.