Active NPI
Carolyn Wray, MS,LAC,CRC
- Professional Counselor
- Malvern, AR
National Provider Identifier
1720419963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A1309102
- Practice address
- 829 Halbert St
Malvern, AR 72104-2607 - Phone
- (501) 332-4400
- NPI assigned
- Dec 12, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | A1309102 | AR | Primary |
Addresses
Primary practice location
829 Halbert St
Malvern, AR 72104-2607
Mailing address
687 Lakeside Rd
Hot Springs, AR 71901-7342
Phone (501) 282-4637
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A1309102 | AR | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386806400000",
"number": "1720419963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "687 LAKESIDE RD",
"city": "HOT SPRINGS",
"state": "AR",
"postal_code": "719017342",
"telephone_number": "501-282-4637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "829 HALBERT ST",
"city": "MALVERN",
"state": "AR",
"postal_code": "721042607",
"telephone_number": "501-332-4400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WRAY",
"first_name": "CAROLYN",
"name_prefix": "Mrs.",
"credential": "MS,LAC,CRC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-12-12",
"last_updated": "2013-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AR",
"license": "A1309102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malvern, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.