Timothy C. Bray, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

941 Issued in NH

Practice address

76 Northeastern Blvd Ste 36a
Nashua, NH 03062-3196

Phone

(603) 881-7554

Fax

(603) 881-7533

NPI assigned

Jun 17, 2006

Last updated

Sep 21, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NH

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

Clinical Psychologist

Education

Other, 1998

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Willowdale Counseling Center PLLCGroup PAC ID 4385889112, 4 clinicians

Willowdale Counseling Center II PLLCGroup PAC ID 4486129442, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Willowdale Counseling Center, PLLC

  • Clinical Psychologist
  • Nashua, NH
  • NPI 1376635102
  Medicare reassignment Care Compare group NPD Authorized official
• Willowdale Counseling Center II PLLC

  • Psychologist
  • Nashua, NH
  • NPI 1356208912
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1699710509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "WILLOWDALE COUNSELING CENTER",
            "address_2": "76 NORTHEASTERN BOULEVARD, UNIT 36A",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030623196",
            "telephone_number": "603-881-7554",
            "fax_number": "603-881-7533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 NORTHEASTERN BLVD STE 36A",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030623196",
            "telephone_number": "603-881-7554",
            "fax_number": "603-881-7533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAY",
        "first_name": "TIMOTHY",
        "middle_name": "C.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7920",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NH",
            "license": "941",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEHAVIORAL HEALTH NETWORK",
            "identifier": "06Y000951NH01",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30421223",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Marie Bradshaw, NP
• Branches Whole Health
• Craig Brand, BA
• Beckie Brannen, ATC
• Harjeet S Brar, DDS
• Leah K Breckenridge, MA
• Audreigh Anna Brede, PT, DPT
• Rebecca Jean Brench
• Brooke Brennan-Mungovan
• Fabrice Brenot, O.D.

• Clinical Psychologist in Nashua, NH
• Providers in Nashua, NH by specialty
• Clinical Psychologist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; 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.